In considering treatment decisions, your personal values are key. Is your main desire to have the most days of life? Or, would your focus be on quality of life, as you see it? What if an illness leaves you paralyzed or in a permanent coma and you need to be on a ventilator? Would you want that? What makes life meaningful to you? If your heart stops or you have trouble breathing, would you want to undergo life-saving measures if it meant that, in the future, you could be well enough to spend time with your family?
Would you be content if the emergency leaves you simply able to spend your days listening to books on tape or gazing out the window? For some people, staying alive as long as medically possible, or long enough to see an important event like a grandchild's wedding, is the most important thing. An advance directive can help to make that possible.
Others have a clear idea about when they would no longer want to prolong their life. An advance directive can help with that, too. Your decisions about how to handle any of these situations could be different at age 40 than at age Or, they could be different if you have an incurable condition as opposed to being generally healthy.
An advance directive allows you to provide instructions for these types of situations and then to change the instructions as you get older or if your viewpoint changes.
There are two main elements in an advance directive—a living will and a durable power of attorney for health care. There are also other documents that can supplement your advance directive.
You can choose which documents to create, depending on how you want decisions to be made. These documents include:. Living will.
A living will is a written document that helps you tell doctors how you want to be treated if you are dying or permanently unconscious and cannot make your own decisions about emergency treatment. In a living will, you can say which of the procedures described in the Decisions That Could Come Up section you would want, which ones you wouldn't want, and under which conditions each of your choices applies. Durable power of attorney for health care.
A durable power of attorney for health care is a legal document naming a health care proxy, someone to make medical decisions for you at times when you are unable to do so. Your proxy, also known as a representative, surrogate, or agent, should be familiar with your values and wishes. This means that he or she will be able to decide as you would when treatment decisions need to be made.
A proxy can be chosen in addition to or instead of a living will. Having a health care proxy helps you plan for situations that cannot be foreseen, like a serious auto accident. Some people are reluctant to put specific health decisions in writing. For them, naming a health care agent might be a good approach, especially if there is someone they feel comfortable talking with about their values and preferences.
A named proxy can evaluate each situation or treatment option independently. Other advance care planning documents. You might also want to prepare documents to express your wishes about a single medical issue or something not already covered in your advance directive. A living will usually covers only the specific life-sustaining treatments discussed earlier.
You might want to give your health care proxy specific instructions about other issues, such as blood transfusion or kidney dialysis.
This is especially important if your doctor suggests that, given your health condition, such treatments might be needed in the future. A DNR do not resuscitate 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. Even though a living will might say CPR is not wanted, it is helpful to have a DNR order as part of your medical file if you go to a hospital.
Posting a DNR next to your bed might avoid confusion in an emergency situation. Without a DNR order, medical staff will make every effort to restore your breathing and the normal rhythm of your heart.
A similar document, called a DNI do not intubate order, tells medical staff in a hospital or nursing facility that you do not want to be put on a breathing machine. If possible, make your advance directive in writing rather than verbally.
State your preferences as clearly as you can, then sign and date it. If you prepare your advance directive with the help of your clinician or another health worker, he or she can verify that you are competent and sufficiently informed about your stated preferences, and can help you clarify the type of situation you intend your directive to cover.
Regularly review and update your advance directive so that it reflects any changes in your condition or your preferences, and is viewed by clinicians as still representing your wishes. Keep a copy of your advance directive yourself, and give copies to your family or support persons, and the clinicians most often involved in your care.
The Code of Health and Disability Services Consumers' Rights sets out your right to be fully informed, make an informed choice, and give informed consent.
However, your advance directive will not override the ability of your clinician to authorise compulsory treatment if you are subject to a compulsory treatment order under the Mental Health Compulsory Assessment and Treatment Act The Mental Health Act also directs the responsible clinician to attempt to get your consent to treatment even though he or she may give you treatment without your consent.
It may still be worthwhile having an advance directive if you are subject to a compulsory treatment order because it will give your clinician an indication of your wishes. Formal investigations. Latest decisions Search decisions Naming policy. A living will tells which treatments you want if you are dying or permanently unconscious. You can accept or refuse medical care.
You might want to include instructions on. A durable power of attorney for health care is a document that names your health care proxy. Your proxy is someone you trust to make health decisions for you if you are unable to do so. The information on this site should not be used as a substitute for professional medical care or advice. If you regain the ability to make your own medical decisions, your proxy agent can't continue to make medical decisions on your behalf.
The person you name as a proxy or agent should be someone who knows you well and someone you trust to carry out your wishes. Your proxy or agent should understand how you would make decisions if you were able, and should be comfortable asking questions and advocating to your health care team on your behalf. Be sure to discuss your wishes in detail with that person. You may also choose to name a back-up person in case your first choice becomes unable or unwilling to act on your behalf.
Durable power of attorney laws vary from state to state. Talk to your health care team and check your state laws. A POLST form has a set of specific medical orders that a seriously ill person can fill in and ask their health care provider to sign.
A POLST form addresses your wishes in an emergency, such as whether to use CPR cardiopulmonary resuscitation in an emergency, or whether to go to a hospital in an emergency and be put on a breathing machine if necessary, or stay where you are and be made comfortable.
Without a POLST form, emergency personnel are required to provide every possible treatment to help keep you alive. POLST forms are only available in some states. Resuscitation means medical staff will try to re-start your heart and breathing using methods such as CPR cardiopulmonary resuscitation and AED automated external defibrillator.
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