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Types of Healthcare Directives

Types of Healthcare Directives

Advanced healthcare directive planning can make difficult healthcare decisions less stressful.

Expressing end-of-life wishes can be challenging, especially in the face of a serious injury or terminal illness. When it comes to your health care and preferred health care, preparing an advanced health care policy is both smart and convenient. Preparing in advance can make difficult healthcare decisions less stressful.

Understanding Advance Directives

An advance health care directive is a written legal document that sets out your health care wishes if you cannot communicate or make decisions. This usually happens when you are medically determined to be terminally ill or permanently unconscious by two or more doctors.

In this document, you appoint someone as your agent to oversee the carrying out of your healthcare wishes and preferences by healthcare professionals such as doctors, nurses, specialists, etc. Each state has its eligibility requirements.

The terminology, content, revocation, and health laws differ depending on your state. These changes will largely determine who you can designate, what treatment you can refuse or request, and how you can change or revoke your policy.

Is an advanced health care directive the same as the living will?

A living will is a statement of your health care wishes. It does not normally include the appointment of an agent. An Advanced Healthcare directive is a living will and a power of attorney.

A living will is also known as a healthcare declaration, physician's directive, health care directive, or advance medical directive.

On the other hand, a power of attorney is known as medical power of attorney, a designation of surrogate, patient advocate designation, and health power of attorney, depending on which state you live in.

What is a healthcare agent?

A health care agent, also known as a patient advocate, health care advocate, surrogate, or health care representative, is an appointee with an enduring power of attorney. Once the Power of Attorney is dated and signed, that person is empowered to carry out your health care wishes if you cannot make healthcare decisions yourself.

Limit the agent's authority by adding exact details to the power of attorney that lists what they are permitted to do and cannot do on your behalf. Some state laws may also limit the agent's authority over health care. A health care statement usually accompanies a power of attorney.

An agent is usually a family member or a close friend over 18. The following are restricted and cannot be referred to as healthcare professionals:

  • An employee, operator, health care supervisor, or owner of a healthcare facility where you receive treatment or live

  • Your attending physician, unless they are related by blood or marriage

  • Your conservator.

Ensure to check your state's requirements, as states have different requirements and/or variations for agent eligibility.

What is a healthcare proxy?

A healthcare proxy allows you to appoint an individual to make key medical decisions for you if you cannot make decisions or communicate your wishes. The person you appoint will step into your shoes and decide for you. The health advocate can only act when you are unable to make decisions. Depending on your condition, a healthcare proxy may need to decide if you should have a ventilator, dialysis, tube feeding, blood transfusions, and other life-saving or prolonging options. For example, if you were in a coma for 24 hours but then woke up, your healthcare proxy would only have the authority to make medical decisions for you during those 24 hours.

Who should I choose as my healthcare agent?

When choosing a healthcare agent, it is important to choose someone who respects your wishes. If you choose someone as your agent, you need to let them know how you feel about aggressive treatment when you're faced with a situation where you won't recover.

What if I don't have anyone to appoint?

Many seniors have no close relatives or friends to appoint. If you do not have someone to appoint, in some cases, a social worker or an elder law attorney can be appointed.

Why do I need a healthcare proxy?

Without a healthcare proxy, if something unexpected happens to you and you can no longer make healthcare decisions yourself, the court must appoint an agent to make the decisions for you. The decision will be out of your control. Sometimes, a stranger may make important life-and-death decisions for you.

Who should have a copy of my medical power of attorney?

Your healthcare agent and doctor should have a copy of the medical power of attorney and any advance directives.

What is a DNR (do not resuscitate) Order?

A Do Not Resuscitate, or DNR Order, is a patient's directive when they do not wish to receive CPR (cardiopulmonary resuscitation). The DNR is not a directive in itself. It is only in addition to other health recommendations in the patient's health declaration. This order is usually given by seriously ill patients who do not want further treatment if they lose consciousness.

What is a POLST Form?

A POLST, or "Physician's Order for Life-Sustaining Treatment" form, is a document that adds more detailed health instructions, wishes, and preferences. These can include artificial nutrition and hydration, medications, intubation, and other methods by which a doctor can perform the life-saving treatment.

Canceling or changing your advance health care directive

In several cases, to cancel a directive, you will make a written statement revoking your current directive. A written statement must be dated and signed in the presence of witnesses.

To make changes, written statements expressing unambiguously the desired changes are acceptable. If not, you can revoke the original Advance Health Policy by executing a new one according to your state's formal requirements.

Note that requirements for advance directives, powers of attorney, and declarations vary depending on the state where you live. It's best to check your state's requirements and procedures before developing your policies to make sure they're properly enforced if you need them.



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