When you create an advance directive, you’re building a blueprint that keeps your wishes front and center. At Remita Health, this blueprint you create becomes the foundation for your end-of-life plan.
An Advance Directive (also known as advance health care directive, living will, personal directive, medical directive or advance decision) is a legal document in which you specify what action should be taken if you are no longer able to make decisions for yourself, because of illness or incapacity.
There are two types of advance directives, the Living Will and the Durable Power of Attorney (DPOA) for Health Care (also known as health care proxy). A living will is a formal legal document designed to control certain future health care decisions when you are unable to make your own decisions and choices due to a terminal illness, or during permanent unconsciousness. The living will describes the type of medical treatment you would want or would not want in these situations. It must be written and signed by you. Five Wishes is a living will form we have available as an advance directive.
The DPOA is a legal document in which you name someone to be your agent (proxy) to make all health care decisions if you become unable to do so. The agent you choose decides which treatment or procedures you want or do not want. If your wishes in a certain situation are not known, the agent will decide based on what he or she thinks you would want.
It is recommended to have both a living will and DPOA, as the living will does not appoint someone as a decision-maker and only covers specific instructions written in it, but does not cover every health care situation that may occur.
You can also create an Individual Health Care Instruction by writing down your health care wishes, or by talking with your doctor and asking him/her to record your wishes in your medical file. If you know when you would or would not want certain types of treatments, a Physician Orders for Life-Sustaining Treatment (POLST) provides a good way to make your wishes clear to your doctor and to anyone else who may be involved in deciding about treatment on the person’s behalf.
POLST can be used together with an advance directive, but not replace it. All adults should have an advance directive, but note that an advance directive does not necessarily give medical orders, whereas POLST does.
Ask your doctor, nurse, social worker, or health care provider for more information. You can have a lawyer write an advance directive for you, or you can complete an advance directive by filling in the blanks on the Five Wishes form.
You can if you are 18 years or older and are capable of making your own medical decisions. You do not need a lawyer.
Your doctors will give you information and advice about treatment. You have the right to choose. You can say “Yes” to treatments you want. You can say “No” to any treatment that you don’t want—even if the treatment might keep you alive longer.
Your doctor will tell you about your medical condition, and explain the different treatments and pain management alternatives available for you. Many treatments have “side effects.” Your doctor will give you information about problems that medical treatments are likely to cause. Oftentimes, more than one treatment may help you—and people may have different ideas about which is best. Your doctor can tell you which treatments are available, but your doctor cannot choose for you. That choice is yours to make and depends on what is important to you.
Yes. Patients often turn to their relatives and close friends for help in making medical decisions. These people can help you think about the choices you face. You can ask the doctors and nurses to talk with your relatives and friends. They can ask the doctors and nurses questions for you.
Yes. You may tell your doctor that you want someone else to make health care decisions for you. Ask the doctor to list that person as your health care “surrogate” in your medical record. The surrogate’s control over your medical decisions is effective only during treatment for your current illness or injury, or if you are in a medical facility, until you leave the facility.
If you haven’t named a surrogate, your doctor will ask your closest available relative or friend to help decide what is best for you. Most of the time that works. But sometimes everyone doesn’t agree about what to do. That’s why it is helpful for you to indicate in advance what you want to happen in the event you can’t speak for yourself.
No. In fact, it is better to choose before you get very sick or have to go into a hospital, nursing home, or other health care facility. You can use an Advance Health Care Directive to indicate who you want to speak for you and what kind of treatments you want. These documents are called “advance,” because you prepare one before health care decisions need to be made. They are called “directives,” because they state who will speak on your behalf and what should be done.
In California, the part of an advance directive you can use to appoint an agent to make health care decisions is called a Power of Attorney for Health Care. The part where you can express what you want done is called an Individual Health Care Instruction.
You can choose an adult relative or any other person you trust to speak for you when medical decisions must be made.
Usually, a health care agent will make decisions only after you lose the ability to make them yourself. But, if you wish, you can state in the Power of Attorney for Health Care that you want the agent to begin making decisions immediately.
After you choose your agent, talk to that person about what you want. Sometimes, treatment decisions are hard to make, and it truly helps if your agent knows what you want. You can also write your wishes down in your Advance Directive.
You can still write out your wishes in your Advance Directive, without naming an agent. You can say that you want to have your life sustained as long as possible, or you can say that you would not want treatment to continue your life. Also, you can express your wishes about the use of pain relief or any other type of medical treatment. Even if you have not filled out a written Individual Health Care Instruction, you can discuss your wishes with your doctor, and ask your doctor to list those wishes in your medical record. You can also discuss your wishes with your family members or friends, but it will be easier for medical personnel to follow your wishes if they are written down.
You can change or cancel your Advance Directive at any time, as long as you can communicate your wishes. To make changes to your Advance Directive, you must sign a statement or tell the doctor in charge of your care.
The same rules apply to anyone who makes health care decisions on your behalf—a health care agent, a surrogate whose name you gave to your doctor, or a person appointed by a court to make decisions for you. All are required to follow your Health Care Instructions, or if none, your general wishes about treatment, including stopping treatment. If your treatment wishes are not known, the surrogate must try to determine what is in your best interest.
Absolutely. You will still get medical treatment. We want you to know that if you become too sick to make decisions, someone else will have to make them for you.