Advance Directives Many people today are worried about the medical care they would receive if they become terminally ill or are unable to communicate. Each person’s thoughts and feelings on these topics are unique. Some may not want to spend months or years dependent on life-support machines, others may want every measure to be taken to sustain their life. So how do you make sure your wishes are known before the time comes in which you may not be able to speak for yourself? A growing number of people are taking action before they become seriously ill. You may state your healthcare preferences in writing, while you are still healthy and able to make such decisions. While these issues are often among the most private and difficult to make, a good place to start is with a review of information. The documents Ideally, the process of discussing and writing advance directives should be ongoing, rather than a single event. Advance directives can be modified as a patient's situation changes. Even after advance directives have been signed, patients can change their minds at any time. A living will is a set of instructions documenting a person's wishes about medical care intended to sustain life. It is used if a patient becomes terminally ill, incapacitated, or unable to communicate or make decisions. Everyone has the right to accept or refuse medical care. A living will protects the patient's rights and removes the burden for making decisions from family, friends, and physicians. A health care proxy is an agent (a person) appointed to make a patient's medical decisions if the patient is unable to do so. Generally, people assign someone they know well and trust to represent their preferences when they can no longer do so. The durable power of attorney for health care is the legal document that names a patient's health care proxy. Once written, it should be signed, dated, witnessed, notarized, copied, distributed, and incorporated into the patient's medical record. Patients may also want to appoint someone to manage their financial affairs if they cannot. This is called a durable power of attorney for finances, and is a separate legal document from the durable power of attorney for health care. Do Not Resuscitate Order Most patients who die in a hospital have had a DNR order written for them. Patients who are not likely to benefit from CPR include people who have cancer that has spread, people whose kidneys don't work well, people who need a lot of help with daily activities, or people who have severe infections such as pneumonia that require hospitalization. If you already have one or more of these conditions, you should discuss your wishes about CPR with your doctor, either in the doctor's office or when you go to the hospital. It's best to do this early, before you are very sick and are considered unable to make your own decisions. Can I change my Advance Directive? If you do not have time to put your changes in writing, you can make them known while you are in the hospital. Tell your doctor and any family or friends present exactly what you want to happen. Usually, wishes that are made in person will be followed in place of the ones made earlier in writing. Be sure your instructions are clearly understood by everyone you have told. Useful Tool Advance Directives Workbook: “Caring Conversations” To view and print a copy of this workbook, visit: For More Information… Decisions About End-of-Life Care Put It In Writing Information on Organ Donation
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