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You Need Advanced Directives

You’ve got your will and your durable power of attorney. But you’re not finished quite yet putting your legal affairs in order, right? Not until you complete your advanced directives.  

This is often confusing for people and that’s not your fault. This group of legal documents are often referred to by different names. So, we’ll simplify this for you.

The name, Advanced Directives (plural), refers to a group of legal documents that provide direction by you in advance of needing them, including:

Living Will

A living will is also known as an advance healthcare directive, personal directive, advance directive, medical directive or advance decision. It is a legal document in which you specify what actions should be taken about end-of-life medical treatment. It lays out the procedures (e.g. use of feeding tubes or respirators, CPR) or medications (e.g. pain meds, antibiotics) you want—or don’t want—to prolong your life if you can’t talk with the doctors yourself. A living will is there to step in when you’re still alive but in an unconscious or terminal state, unable to voice your medical care wishes.

Don’t confuse a living will with your will and last testament. Think of it like this: Your last will tells people what you want to happen after you die. A living will tells them what you want to happen while you’re still living.

Medical Power of Attorney

A medical power of attorney is also known as a healthcare power of attorney, durable power of attorney for health, or health care proxy. This is not unlike the power of attorney we discussed previously. In this case, it is a “limited” power of attorney, specifically for medical decisions. So instead of a piece of paper (living will) providing direction, you have a person you trust acting in your best interests while honoring your original wishes. So, you would need to have a conversation with them to make sure they know how you feel about important medical decisions.

Living Will or Medical Power of Attorney?

You can have both a living will and a medical power of attorney, but it could cause a conflict of interest. If that happens, your living will—your original wishes—will prevail over the power of attorney (paper over person). A living will is probably the best option if you do not have a person you can trust to act in your best interests. On the other hand, if you do have such a person, a medical power of attorney is a lot more flexible than a living will, and the person you trust will have a lot more power to do what’s best for you during crucial moments.

Other Directives

There are other legal documents to consider when putting your Advanced Directives in place:

  • Do Not Resuscitate (DNR) Order. This order tells medical staff in a hospital or nursing facility that you do not want them to try to return your heart to a normal rhythm if it stops or is beating unsustainably using CPR or other life-support measures. Sometimes this document is referred to as a DNAR (do not attempt resuscitation) or an AND (allow natural death) order. Without a DNR order, medical staff will make every effort to restore your breathing and the normal rhythm of your heart.
  • Organ and Tissue Donation. This allows organs or body parts from a generally healthy person who has died to be transplanted into people who need them. Commonly, the heart, lungs, pancreas, kidneys, corneas, liver, and skin are donated. There is no age limit for organ and tissue donation. You can carry a donation card in your wallet. Some states allow you to add this decision to your driver’s license.

  • POLST and MOLST Forms.  These forms provide guidance about your medical care preferences in the form of doctor’s orders. Typically, you create a POLST (Physician Orders for Life-Sustaining Treatment) or MOLST (Medical Orders for Life-Sustaining Treatment) when you are near the end of life or critically ill and know the specific decisions that might need to be made on your behalf. These forms serve as a medical order in addition to your advance directive. They make it possible for you to provide guidance that health care professionals can act on immediately in an emergency. The doctor fills out a POLST or MOLST after discussing your wishes with you and your family. Once signed by your doctor, this form has the same authority as any other medical order.  

It is difficult to predict the future with certainty. You may never face a medical situation where you are unable to speak for yourself and make your wishes known. But having an advance directive may give you and those close to you some peace of mind.