Advanced Directives

Sunday, September 5th, 2010

While working with patients and families in our hospice program, we are often asked about advance directives. What exactly are advance directives and who needs them? Below you will find some helpful facts and common myths surrounding these important documents.

What are “Advance Directives?”
Advance directives are legal documents that state your choices about medical treatment or name someone to make decisions about your medical treatment, if you are unable to make those decisions for yourself. They are called “advance” directives because they are made in advance to let your doctor and other health care providers know your wishes concerning medical treatment. Through advance directives you can make legally valid decisions about your future medical care. In Idaho there are two types of advance directives:

An Idaho Durable Power of Attorney for Health Care identifies the person whom you choose to make decisions about your medical care − including life support − if you become unable to speak for yourself. This person speaks for you any time you are unable to make your own medical decisions, not only at the end of life.
The Idaho Living Will states your wishes about medical care in the event you become terminally ill or in a persistent vegetative state. Your Living Will becomes effective when two doctors certify that you are terminally ill and that your death will occur with or without the use of life-sustaining procedures, or that you are in a persistent vegetative state.

Your agent (or proxy) is the person you appoint to make decisions regarding your medical care in an Idaho Durable Power of Attorney for Health Care document. This person should be someone you trust who clearly understand your wishes, and is willing to accept the responsibility of making medical decisions for you. Both documents must be in writing and signed in the presence of witnesses, who must also sign the documents to show that they personally know you and believe you to be of sound mind. There are some restrictions as to who may serve as your agent and witnesses.

Myths about advance directives
Below are some of the more common myths associated with advance directives.

A lawyer is required to complete an advance directive. Although a lawyer may be helpful, it is not required. Information on completing both documents is available from several sources. (See www.partnershipforcaring.org for details.)
An advance directive means “don’t treat.” This is not true at all. An advance directive does not say, “do not treat” but actually says “treat me the way I want to be treated.”
Advance directives are legal tools for the elderly or infirm. False! Everyone over 18 years of age will benefit from an advance directive, which safeguards their right to choose or refuse specific health care interventions.
There is only one type of Power of Attorney. There are actually many types of Power of Attorney. They are typically separate legal documents, which address different issues.
Once a person names an agent/proxy in an advance directive, they lose control of their own care. False again! As long as a person retains decision-making capacity, they retain control of their medical care. This document only becomes effective when a person is unable to speak for himself or herself.
Advance directives are permanent. Not true. Although they are legal documents they are also flexible and may be changed or revoked at any time.

Important benefits
According to Connie James, MSW, of Life’s Doors Hospice, there are two invaluable benefits one receives when executing advance directives. “First, these documents create a sense of security and peace of mind. People feel safe knowing that their wishes will be met. Second, they remove a burden from the family. Loved ones no longer have to guess what type of treatment a patient may wish to receive,” states James. “Assistance with advance directives is one of the more common services we offer our clients.”

As you can see, advance directives are very important in expressing medical care wishes and desires, regardless of age or health. Assistance on advance directives is available from your legal professional, Partnership For Caring (800-989-9455), Idaho Medical Association (208-344-7888), or Life’s Doors Hospice (208-344-6500.)

Sources:
Life’s Doors Hospice, 420 S. Orchard, Boise, Idaho 83704
Partnership For Caring, 1602 Eye Street, NW Suite 202, Washington DC, 20006
Idaho Medical Association, 305 W. Jefferson, Boise, Idaho 83701