Creating a new advance directive can feel like the end of the process. You reviewed your wishes, made the changes you wanted, signed the new document, and now have an updated plan.
There is still one important step left.
What happens to all the copies of your old advance directive?
An outdated copy may still be sitting in a physician’s records, with your healthcare agent, in a folder at home, or somewhere else you provided it years ago. If you update your advance directive, making sure the right people have the new version can be just as important as making the changes themselves.
Why an Old Advance Directive Can Create Confusion
Advance directives are meant to provide clear information about your healthcare wishes if you cannot communicate or make certain decisions yourself.
Over time, those wishes can change. You may also decide that you want a different person to serve as your healthcare agent. A new diagnosis, marriage, divorce, death in the family, or simply a change in your own thinking may lead you to update your documents.
Once you create a new advance directive, however, the old copies do not disappear automatically.
Someone you trusted with a copy years ago may still have it. A healthcare provider may have the previous version in your medical record. You may even have several copies at home and no longer remember which one is current.
That can defeat one of the main purposes of an advance directive: providing clear guidance when it is needed.
Start by Identifying Who Has a Copy
After creating a new advance directive, think about who received the previous version.
That may include your primary care physician, specialists, healthcare agent, alternate agent, close family members, hospital, nursing home, or another healthcare facility.
The Mayo Clinic recommends giving new copies to your healthcare professional and others who need them, getting rid of old copies, and making sure the new directive replaces the old one in your medical file.
Let the appropriate people and providers know that you have updated your advance directive and provide the new version.
Replacing outdated copies helps reduce the chance that someone will rely on instructions that no longer reflect your wishes.
Make Sure Your Healthcare Agent Has the New Version
Your healthcare agent should receive a copy of your updated advance directive and understand any changes you made.
If you have the same healthcare agent, talk with them about any changes to your instructions or preferences so they understand what matters to you.
If you chose a new healthcare agent, make sure that person knows about the responsibility and has access to the current document.
An alternate healthcare agent should also have the updated version. If your first choice cannot serve when needed, you do not want the alternate relying on an outdated copy.
Check With Your Healthcare Providers
Your physician may have asked for an advance directive at some point. If you provided one, it may still be part of your medical record.
After an update, do not assume the new document will somehow replace it on its own.
Provide the updated advance directive and ask that it replace the prior version in your record. If other healthcare providers or facilities also received the previous document, consider whether they need the new one as well.
Mayo Clinic specifically recommends making sure a new directive replaces an old directive in your medical file. It also notes that updated directives should be added to medical charts at hospitals or nursing homes.
This step becomes especially important if you receive ongoing care from several providers.
Look for Old Copies at Home
Old versions can create confusion at home too.
Perhaps you kept the original in an estate planning binder and placed another copy in a desk drawer. Maybe your spouse has one, or you gave copies to your adult children.
Once the new document is complete, go through the places where you normally keep important paperwork. Remove outdated versions so someone searching for your advance directive during an emergency does not find the wrong one first.
If you keep an older version for your own records, clearly identifying it as outdated may help prevent it from being mistaken for the current document. However, requirements for changing or revoking advance directives can vary by state. Follow the instructions that apply to your document and state.
Don’t Forget About Digital Copies
Paper is not the only place an old advance directive can remain.
You may have saved a PDF on a computer, phone, tablet, cloud storage account, or another digital location. Perhaps you also emailed a copy to yourself or to a family member.
Look for those older digital copies as you update the people and providers who have your directive. An outdated file can create the same confusion as an outdated paper copy if someone later mistakes it for the current version.
As you save the new directive, give the file a clear name that makes the current version easy to identify. Including the date can help distinguish it from earlier versions.
Check the Information Connected to Your Directive
You may have updated your advance directive because your wishes changed or because you made a different decision about your medical care. While you are making that update, it is also a good time to make sure the other information connected to the document is still current.
Check the contact information for your healthcare agent and alternate agent. Make sure they are still willing and able to serve, and confirm that your healthcare providers have the correct information for the people you selected.
If any of those details have changed, update them at the same time so the new version reflects your current wishes and circumstances.
The Current Version Needs to Be the Accessible Version
An advance directive is most useful when the people who need it can obtain the correct version.
That is why updating a directive should include more than signing a replacement. The process should also include replacing outdated copies, notifying the appropriate people, and making sure healthcare providers have current information.
It can help to keep a simple record of who has received your directive. Then, if you make another change later, you already know where new copies need to go.
The goal is straightforward: if your advance directive is ever needed, there should be as little uncertainty as possible about which version reflects your wishes.
Keeping Your Updated Advance Directive Accessible
Once you have replaced the old copies, think about how the current advance directive will be available when it is needed.
Legal Directives provides members with another way to keep healthcare directives accessible.
Members’ current documents are stored so they can be accessed 24 hours a day, seven days a week.
Documents can be downloaded or sent by fax or email when a copy is needed.
Members also receive an Emergency Wallet Card that helps identify that their healthcare directives are available.
If you update your advance directive, make sure Legal Directives has the new version too. Once the updated document is in your account, you can also send it by fax or email to your physician or another healthcare provider right away.
That helps keep the version available through your membership consistent with the one you want your healthcare agent and providers to use.
Creating a new advance directive is an important step. Making sure the old one is no longer the version people find may be just as important.
Source
Mayo Clinic, “Living will and advance directives for medical decisions,” Read the full article here.