Search as I might, I couldn’t find an Aging Matters column on advance directives, though it seemed there had been one. The topic is a natural continuation of June’s column on powers of attorney.
What it is: An advance directive provides instructions about future medical care in the event one becomes incapable of stating one’s own wishes.
What it looks like: Think of a three-legged stool. One leg is the durable power of attorney for health care. It authorizes someone whom you trust and who knows your wishes to make decisions about your medical care if you can’t make the decisions yourself. The person you designate becomes your “health care agent.”
The second leg is a document stating your wishes, known as the health care directive — also known as the living will or directive to physician. The health care directive states whether or not you want life-sustaining treatments such as resuscitation, artificial respiration or artificial nutrition.
The third leg of the stool is a just-in-case document called a POLST — Physician Orders for Life Sustaining Treatment — which expresses your end-of-life wishes as medical orders. It’s normally only needed by people who have a serious, life-limiting medical condition, the POLST is only valid when signed both by you and a physician. It has the advantage of traveling with you between facilities.
How to make advance directives: A couple of resources have served us well. Both my husband’s mother and mine used an all-in-one form loaded with information from Compassion & Choices of Washington. It allowed our mothers to opt for or against specific life-sustaining treatments, name a health care agent, state preferences about comfort care, and consent to or refuse such matters as organ donation. The website is www.compassionwa.org
Another good source is provided by Caring Connections. Go to www.caringinfo.org to view and download their forms, which cover everything mentioned here except POLST.
Your health care directive must be witnessed by two adults who are not employed by a health care facility where you reside, not your physician, not your heir, or related to you. Notarizing the statement isn’t required but is a very good idea.
Copies of Advance Directives are valid and should be kept handy. Don’t put it in a safe deposit box and make sure that your Health Care Agent and others who need to know about it know what’s in it and where to locate it. You might like to know that in a medical emergency such as a life-threatening car accident, you would have to have a valid POLST with you to supersede the life-sustaining/resuscitation efforts of ambulance personnel.
