If a medical emergency left you unable to communicate, would the right documents be in place to help guide your care?
An advance healthcare directive is a legal document that helps you plan for future healthcare decisions in case you become unable to make or communicate those decisions yourself. Advance directives can take different forms and serve different purposes. Some provide instructions about your preferences for future medical care. Others name a person who can make healthcare decisions on your behalf.
In other words, an advance directive gives you a way to make important healthcare choices ahead of time, while you are able to consider and communicate them clearly.
Understanding the Different Types of Advance Directives
States use different language for advance directives. The terminology also depends on what the document is designed to do.
In its guidance on advance directives, Mayo Clinic distinguishes between a living will and a healthcare power of attorney, which serve different purposes.
A living will focuses on your wishes for medical care. It can address specific medical treatments and when you would want to receive or decline them. For example, it may include instructions about treatments used to sustain life.
A healthcare power of attorney names someone you trust to make healthcare decisions if you cannot make those decisions yourself. Depending on where you live, you may hear other terms associated with this role. These can include healthcare proxy, healthcare agent, or healthcare surrogate.
Together, these types of advance directives can address two important questions: What care would you want? Who would you trust to make decisions if you could not make them yourself?
What Decisions Can an Advance Healthcare Directive Address?
It can be difficult to imagine every medical situation that could arise. An advance healthcare directive does not need to predict every possibility. Instead, it gives you an opportunity to document important preferences and provide guidance for future decisions.
A living will, for example, may address decisions about cardiopulmonary resuscitation (CPR), mechanical ventilation, tube feeding, dialysis, certain medications, and comfort care. It may also address organ and tissue donation. The specific choices included in a living will can depend on the document and your circumstances.
Thinking through these decisions can involve more than choosing individual treatments. Your wishes may also reflect what matters to you personally. Mayo Clinic encourages people to consider their values, including how they feel about independence and the circumstances in which they would want treatment to extend their lives.
These are personal decisions. Discussing medical questions with your healthcare provider can help you better understand different treatments and what those choices could mean for your care.
Choosing Someone to Make Healthcare Decisions
A healthcare power of attorney addresses a different part of the planning process. Rather than trying to put instructions in writing for every possible situation, you choose someone who can make healthcare decisions for you if the need arises.
Choosing that person deserves careful thought. Someone may know you well but feel uncomfortable making difficult medical decisions. Another person may understand your wishes but struggle to speak up when family members disagree.
Choosing a healthcare agent involves more than selecting someone you trust. Consider whether the person is comfortable discussing medical care, understands your wishes and values, and can speak up for you if difficult decisions or disagreements arise.
The conversation matters, too. Naming someone in a document gives that person an important responsibility. Talking about your preferences beforehand can give your healthcare agent a clearer understanding of what matters to you if that person ever needs to act on your behalf.
Advance Directives Are Not Only for Older Adults
It is easy to associate advance healthcare directives with aging or a serious diagnosis. However, the need to communicate healthcare wishes can arise at any age.
An accident or sudden illness can affect someone at any age and may leave an otherwise healthy adult unable to make or communicate healthcare decisions.
That is one reason advance care planning does not have to begin with a health crisis. Preparing in advance gives you time to think about your choices, ask questions, and communicate with the people you trust without the pressure of an emergency.
Your Advance Directives May Need to Change
Completing your advance directives is not necessarily the end of the planning process. Your health, relationships, and preferences can change over time.
A new diagnosis may change how you feel about certain medical treatments. Marriage, divorce, separation, or the death of someone close to you may affect whom you want to make decisions on your behalf. Even without a major life event, your views about future medical care may evolve.
For these reasons, it is worth reviewing your advance directives periodically to make sure they still reflect your wishes and circumstances.
Reviewing your documents also gives you an opportunity to make sure the people involved still understand your wishes. If you update your directives, make sure the appropriate people receive the current versions.
Once Your Advance Directives Are Complete
Completing your advance directives is an important part of planning ahead. There is also a practical question worth considering: where will you keep the documents so they are available when you need them?
Imagine taking the time to prepare your advance healthcare directives, only to have them out of reach when they are needed. An emergency can happen anywhere, which makes access to your documents an important part of the planning process.
Mayo Clinic recommends carrying a wallet-sized card that notes you have advance directives, identifies your healthcare agent, and tells others where to find your directives.
That recommendation aligns with the service Legal Directives provides. Through our Medical Access Program, members receive an Emergency Wallet Card that provides 24/7 access to their stored healthcare directives, three emergency contacts, and other important information that can help in an emergency.
If you already have your advance directives in place, don’t forget about what happens after you sign them. Make sure the documents are stored somewhere they can be accessed when needed. Learn more about our Medical Access Program, sign up for membership, or contact us with questions about getting started.
Ready to learn more about keeping your completed healthcare directives accessible anytime, from anywhere? Explore our Medical Access Program or contact our team with questions.
Mayo Clinic, “Living wills and advance directives for medical decisions.” Read the full Mayo Clinic article.