What is an Advance Directive, and When Should I Get One?
An advance directive is more commonly known as a living will. This legal document outlines all of your wishes regarding your medical care in the event that you become unable to communicate with your health care providers.
During routine medical situations, you are usually awake and alert enough to tell your doctors and surgeons your wishes. You can gather information on medical procedures, make informed decisions, and sign the paperwork necessary to get those decisions underway. In some cases, however, this is not always possible. Whether because you have an accident that renders you incapacitated or because an illness is so advanced that you are no longer capable of making decisions, there may come a time when your doctors will be uncertain how you want to proceed.
Although an advance directive covers many different types of medical treatments, the most commonly addressed issues include the use of:
- CPR and other live-saving techniques
- Machines for breathing, kidney functions, and other life-sustaining technology
- Organ transplants
- Feeding/fluid tubes
- Certain types of medication
The default in these situations is to turn to your next of kin or the individual responsible for your care (usually a spouse, parent, or adult child). While this can work, especially if you have been upfront about your wishes, this places a huge burden on your loved ones. It can also lead to major disagreements in the family that could result in your wishes being overturned. An advance directive is the best—and easiest—way to help avoid this.
Types of Advance Directives
There are two main types of advance directives: a health care directive (or treatment directive), which outlines your wishes on paper; and a power of attorney for health care (or medical power of attorney), which is a legal document that gives someone else the power to make any and all health care decisions for you.
Which of these you decide to use depends on your situation. Most people will find that a treatment directive is sufficient, especially if you have communicated with your loved ones about your health care priorities and end-of-life wishes. However, if there is any chance of disagreement in the family, or if you want to ensure that there is no question of your wishes among the medical staff (particularly if any of the treatments are experimental or contentious), it is best to fill out a medical power of attorney that puts the person you trust most in charge. This power of attorney only goes into effect once medical providers determine that you are unable to make decisions on your own.
It is important to remember that every state has its own rules and regulations regarding advance directives, so do your research before you sign anything or before you travel to another state for treatment. Some states will accept directives from other states; others will not.
When to Get an Advance Directive
The point of an advance directive is to make your wishes clear in case you are unable to communicate them. Few people can guess when and how this will happen, which means it is never too soon to fill one out. If you are doing traditional will planning (whether you are in your twenties or thirties, or if you are doing end-of-life planning later in life), go ahead and consider adding a living will to it. This adds only a nominal amount of time and money, and will ensure that your wishes are known.
Like traditional wills, living wills can be changed and updated at any time. As your life changes, so too might your wishes regarding end-of-life care, so be sure and check every few years to make sure everything is up-to-date and current.