What are advance directives? How to share your end-of-life choices

Less than 4-minute read

If you have family members who rely on you for support in making healthcare decisions, you may be wondering, "What will they do if I'm not there?" A better question is "What are advance directives?" These documents allow people to record their care preferences and let providers know what they might want for their end-of-life care, especially if they're diagnosed with a serious illness.

Start the process of future care planning now, so you can rest assured that your loved ones will have their care needs met.

Why are advance directives so important?

Even if your loved ones are in good health, you can never predict how this might change. That's why it's always a good idea to plan ahead.

Future care planning with a loved one lets you:

• Ensure that you will honor the person's wishes. If you have written proof of your loved one's preferences, you can help them receive the care they prefer.
• Move forward without guilt or second-guessing. Many people who help their loved ones through the end of life feel guilty and uncertain making every choice. By gaining a clear understanding of your loved one's preferences, you can gain peace of mind about your decisions.
  
• Lay out specific guidelines for providers. When your loved one fills out advance directive documents, they can specify which procedures and types of care they would like for the healthcare facility to provide and when not to.

You should make talking to your loved ones about future care planning a priority if you want to avoid uncertainty. Fortunately, there is more than one type of advance directive to ensure your loved one receives their preferred end-of-life care.

Securing ideal treatment with the living will

One of the most essential advance directives, a living will, is a legally recognized written document your loved one completes to state the specific care or treatment they do or do not want during a terminal illness. A living will is used in the event that the patient becomes terminally ill and unable to communicate for themselves.

By filling out a living will, your loved one will be able to:

• List out their treatment preferences
• State whether they would like to be kept on life support
• Elect whether they would like to become an organ donor

A living will does not go into effect until the patient loses the ability to think or speak for themselves. Until then, the patient is still in charge of their own medical decisions. Additionally, your loved one can change their living will at any time.

The durable power of attorney for healthcare and other advance directives

Another advance directive your loved one might want to fill out is a durable power of attorney. By completing this document, a patient can transfer the power to make medical decisions on their behalf and manage care to a healthcare agent or person they trust. If you become your loved one's healthcare agent—sometimes called a proxy, a healthcare representative, or a healthcare power or attorney—you will be responsible for making important medical decisions for your loved one when they no longer can.

A durable power of attorney for healthcare is not the same as a basic and traditional power of attorney document. A traditional power of attorney document often excludes medical decision making. To make a traditional power of attorney document include medical decisions, the patient must have an attorney add in a healthcare clause.

As your loved one's healthcare agent, you might:

Familiarize yourself with your loved one's values. Since you will be speaking on behalf of your loved one, you should do everything you can to make sure you understand their preferences.

Make tough decisions in unexpected situations. You will be responsible for making hard calls when complications arise. If your loved one does not have a living will, then you will have to make these decisions based on your best understanding of your loved one's wishes.
Consent to or refuse treatments on your loved one's behalf. You will have the right to choose how your loved one will receive treatment.

Another common advance directive is Medical Orders for Life-Sustaining Treatment or MOLST. This legal document, which is used in Ohio, can help your loved one express their preferences regarding CPR treatment. By filling out a MOLST document, they can specify whether they would like to receive CPR in a life-threatening situation.

Your loved one might also fill out Physician Orders for Life-Sustaining Treatment, also known as POLST. In Indiana, this form is known as Physician Orders for Scope of Treatment, or POST. This document, only for people who are terminally ill or very elderly, allows your loved one to document specifics about how they would like to receive end-of-life treatment.

How can I talk to my loved ones about advance directives?

The most important thing to remember is that future care planning is an ongoing conversation. As your loved ones age, you should strive to speak with them often about their medical care preferences. To help this process run smoothly, you can:

• Remind your aging family members you love them and want what's best for them.
• Let them know their preferences will be honored if they fill out advance directives.
• Tell them they will make the entire process easier for everyone involved if they invest in future care planning.

Do you have loved ones who are aging or experiencing a serious illness? Help them document their preferences for care with resources from our Deciding Together program.