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Advance Directives - The Choice Is Yours
Compiled by Mindy Greene, licensed social worker
What Are Advance Directives?
Advanced Directives are documents that state a patient's choices about treatment including decisions like refusing treatment, being placed on life-support and stopping treatment at a point that the patient chooses or requesting life sustaining treatment if that is desired. Advance Directives consist of living wills, durable power of attorney for health care and do not resuscitate directive. These documents help you to talk with your family, friends and physician about how you want to be treated if you become seriously ill. When Advanced Directives are on file, your family members will not have to guess what you want and they will not have to make hard choices regarding your healthcare without knowing your wishes.
Living Wills
A living will is a document that allows you to state, in advance, your wishes regarding the use of life-sustaining procedures. It is implemented only when you are terminally ill, and do not have the capacity to make treatment decisions. Before a Living Will is implemented, two physicians must personally examine the patient and determine that the patient has a terminal illness. The physicians must agree that death will occur whether or not the medical procedure or intervention is done. The document is not valid if the patient is pregnant. Medical procedures deemed necessary to provide comfort or alleviate pain are not considered life sustaining procedures. This document must be notarized or witnessed by two adults who are not related to or will not inherit from the person making the living will and who are not financially responsible for the patient. If you do decided to sign a living will, it is your responsibility to see that the appropriate people - your family, physicians, friends, clergy - are provided a copy of the document and it becomes a part of your permanent medical record. It is always best to discuss these issues with the important people in your life so your wishes can be met in case of serious illness.
Durable Power of Attorney for Healthcare
Durable power of attorney for health care is a legal document that relates only to health care decision making. It allows you to name a healthcare agent to make healthcare decisions for you only when you cannot make decisions for yourself. Your healthcare agent may consult with your caregivers and decided on a plan for your care. Your agent informs your caregivers what you would and would not want choose as certain treatments. The healthcare agent can be a family member, friend or a person you trust who knows your religious and other values and who is willing to make healthcare choices for you. The person you select should know how you feel about quality of life choices, hospitalization, hospice, experimental treatments or life sustaining treatments. Your healthcare agent must follow your wishes and your caregivers must respect the choices your healthcare agent makes for you. Talking about these issues may not be easy and many people feel uncomfortable talking about end-of-life care. If your loved ones have to one day make decisions for you it may be difficult, but discussing your choices now will help them.
Do Not Resuscitate Directive
Another important document for your future healthcare treatment is a Do Not Resuscitate directive or DNR. This is a document directing the health care facility as to the wishes of the patient should the patient's heart stop beating or breathing stops. When a DNR is signed by a patient or their durable power of attorney for healthcare, no medical procedure will be done to restart the heart or breathing. A person must be an adult and competent when the paper is signed and a physician needs to write an order to be placed in the patient's chart. It is important to discuss DNR decisions with your physician early before there is an illness or hospitalization. Of course as with any healthcare directive, a DNR can be revoked by the patient at any time. It is important that your physician, family and friends know your wishes should you face a medical crisis.
How To Begin The Conversation...
Talking about these issues with your loved ones may not be easy; there may be resistance, even denial. Many people are uncomfortable talking about end-of-life situations. Begin your conversation by telling your loved ones this is important to you. Let them know that you have been thinking about the kinds of treatment you would want and want to share your thoughts with them. If loved ones have to make decisions for you it may be difficult, but discussing your choices now will help them understanding your desires. If you choose to make advanced directives, Goodland Regional Medical Center can provide the necessary forms you will need. And remember that it is your responsibility to share these forms with your physician and your loved ones. A copy of these documents can be placed in your medical records and it is appropriate to keep a copy for yourself as well as give a copy to family members or friends.
For More Information Check Out These Links:
 Kansas Health Ethics
Aging With Dignity
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