Managing a Loved One’s Medical Decisions

Do you want to control your final days?

Advance directives are legal documents that dictate how a person is cared for in their final days.  So, if a person ends up in a hospital and is unable to communicate their wishes, medical personal will refer to the advance directive to determine treatment.

If you’re moving a family member to a nursing home, you should ensure that the nursing home has a copy of their advance directives.  If your loved one doesn’t have any advance directives, you should take a couple hours to fill some out with them.

There are three basic advance directives: living wills, do no resuscitate orders, and medical powers of attorney.

Living wills

Living wills are documents that dictate what types of life-saving or life-sustaining treatments you want (or don’t want).  For example, you can tell doctors that you don’t want to be kept on feeding tubes.

Living wills can be written out, like normal wills, or they can be a checked form that covers the major types of treatments.  These forms can usually be found online.

Do Not Resuscitate

These documents tell medical personnel not to use CPR or take other life-saving actions in the event the person’s heart or breathing were to stop.  In effect, they state that a person should be left to nature.

Generally, these directives are only used for elderly and terminally ill people — people who do not expect to live long after resuscitation.

Medical Power of Attorney

This document gives a family member (often a spouse, parent or child) or a friend the legal right to make medical decisions for a person if they are unable to on their own (for example, if they are in a coma).

Medical powers of attorney (PoA) are very important, because they give people who you trust the right to make decisions, as opposed to doctors, the law or untrusted family members.  They are the only way to truly protect yourself from treatment disputes, like seen in the Terri Schiavo case of the mid-2000’s.

Though living wills should always be used, they tend to be broad.  PoA’s cover more detailed issues that may arise, including which medicines to use, how long to permit life support, where to be hospitalized, etc.

How to Make an Advance Directive

Each state differs in exactly what is required to create a valid advance directive.  However, all states require that directives be witnessed.

Check your state’s rules to determine exactly what is needed, or consult an attorney or your doctor.  Make sure to include your family member(s) when creating an advanced directive, whether it’s for yourself or a loved one.  If a loved one is lacking in mental capacity, helping them create a living will without the involvement of other family member may lead to disputes.

Where to Keep Your Advance Directives

Whoever has an advance directive should keep it in three places:

• With you – Keep a copy of your living will in your purse or bag.  At the least, keep it with you when you can, especially if going somewhere, like on a vacation.
• With family – Give copies of your advanced directives to trusting family members and/or friends, who can produce them to authorities if anything was to happen to you.
• In the freezer – Yes, seriously.  Paramedics and medical personnel understand this to be the most common place for an advance directive.  They will look here.