What is an Advance Directive?
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As we age it becomes more and more difficult to do things on our own—in some cases this might be the result of physical limitations, while in other cases we might experience some mental limitations. In either case, you may not be able to tell caregivers and medical professionals your preferences for care, which is precisely where an advance directive comes in. Sometimes called a “living will”, this document makes your wishes clear for medical treatments at the end of your life and is something everyone should have.
When Advance Directives Take Effect
Simply having an advance directive doesn’t mean that another person will be making medical treatment decisions for you. Before these documents take effect, the following must be certified by two physicians:
- The patient is unable to make decisions regarding their medical treatment
- The patient has a condition specified in the laws of the state regarding living wills
- Other requirements are met, according to state laws
When that occurs, a person will be appointed to make those decisions for you (a power of attorney), according to your advance directive. If you do regain the ability to make decisions, the power of attorney will no longer be in effect.
Setting Up an Advance Directive
An advance directive is valid in every state in the U.S., and can be set up with or without an attorney. To be legally valid, the document must be signed in the presence of a witness (someone who’s not involved with the advance directive). There may also be other requirements in your state, so make sure you consult the laws and cover all the bases before you think the document is complete.
What You Should Know About Advance Directives
An advance directive is generally meant to help guide medical treatments in situations where you could not make those decisions on your own. However, that doesn’t mean that they are the ultimate deciding factor in every treatment situation. It should be noted that emergency first-responders are required to do whatever they can to stabilize (and save) a person on the way to the hospital. Since only physicians can activate advance directives, they won’t be valid until after arriving at the hospital.
Another important note is that while advance directives are generally enforceable throughout the U.S., that doesn’t always mean they will be valid. In some states they may not be enforced if the laws are substantially different from the state where the directive was made.
Finally, advance directives are not temporary; they will remain in effect until you either replace it with a newer one, or take legal steps to invalidate the previous document. For that reason you should make it a habit to review your advance directive regularly to make sure the wishes expressed in the document reflect your current desires for lifesaving medical care.
Advance directives and planning for the future isn’t something that is exclusive to those who are getting older—everyone over the age of 18 should have an advance directive that helps guide care in the event you become unable to tell the doctors what you want. Think about questions like whether you would want CPR if you have a stroke and your heart stops, or if you have physical or mental impairment and require artificial breathing (a ventilator) or nutrition (feeding tube or IV fluids), or if you develop dementia and cannot recognize your loved ones and need constant supervision and care. Take the steps now to prepare for the unexpected and ensure you are cared for no matter what happens.