Advance Directives
What are advance directives?
Advance directives are legal documents that allow you to make decisions about future medical care. They offer information to health care providers and family members about health care preferences, and are utilized when you become physically or mentally unable to make health care decisions. The most common documents are the Durable Power of Attorney for Health Care and the Living Will.
What is a Durable Power of Attorney for Health Care?
The Durable Power of Attorney for Health Care is a document that allows you to appoint someone else, known as a health care agent, to make future decisions about your medical care. Your agent may be a family member or a friend and do not need to have any medical experience. The person named as your agent should be someone you trust who is capable of making health care decisions that reflect your values and preferences. This person has the legal authority to make all health care decision in the event that you become unable to do so. An alternate agent can be named as well. This document is very different from a General Power of Attorney, which is used for financial matters, and often requires the use of an attorney.
What is a Living Will?
The living will, sometimes referred to as a Declaration Relating to Use of Life-Sustaining Procedures, is a document that directs your physician to withhold or withdraw certain treatments that would prolong the dying process. This document is in effect only when you are near death or in an irreversible coma. Because of its limited use, most people prefer to complete a Durable Power of Attorney for Health Care and incorporate the language of a living will into that document, instead of doing both forms.
Is an attorney needed to complete an advance directive?
No. An attorney is not necessary when completing an advance directive.
Where can I find advance directive forms?
State-specific documents can be downloaded at no charge from the National Hospice and Palliative Care Organization’s website. Both the forms and the instructions are available at www.caringinfo.org. Locate the “Free Downloads” link on the home page and click on “State-Specific Advance Directives.” This page lists all fifty states and allows you to download information for your state of residence. The site also contains a link to Google Health, a website that provides instructions on how to scan your directive, once completed, and make it available online for medical providers of your choice.
Is a witness required to sign the forms?
Every type of advance directive requires a witness to the signature of the person creating the document. Witnessing requirements can vary for each state. Some states require that the signature be witnessed by two adults and some require the signature of a notary. Instructions for each document should be read carefully.
What do I do with the forms once they are completed?
Following the completion of an advance directive, copies should be distributed to your physician, your agent(s), and the hospital of your choice. If you are receiving home health care or hospice services, or are a resident of a nursing home or assisted living facility, a copy should be provided to them as well. You should keep the original document yourself, and store it in a safe location, easily accessible and known to your family.
What if I have a Durable Power of Attorney for Health Care and want to change it?
A Health Care Power of Attorney document can be changed easily at any time. It can be revoked orally, by simply stating you no longer want it to be in effect. A new document should be created whenever an existing document no longer reflects your wishes. The creation of a new document invalidates all previous documents. Copies of the previous document should be retrieved and destroyed in order to eliminate confusion.
What is meant by "DNR" or "Do Not Resuscitate"?
DNR means that the patient does not want chest compression, mouth to mouth resuscitation or an ambulance called at the time of death. Death will be allowed to occur peacefully and comfortably. All efforts will focus on managing symptoms through the time of death and not on prolonging the dying process. The choice to be "DNR" is not required for admission to Hospice of Dubuque.
For additional questions about advance directives, please contact a member of the Hospice of Dubuque social work staff. They will be happy to offer whatever assistance you might need.