Advance care directives

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Medical power of attorney

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Living will. This is a written, legal document that conveys the wishes of a person in the event of serious illness. This document can speak for a patient who is unable to communicate. A living will may indicate specific care or treatment the person does or does not want performed under specific circumstances. This may include specific procedures, care, or treatments such as the following:

• CPR (if cardiac or respiratory arrest occurs)
• Artificial nutrition through intravenous or tube feedings
• Prolonged maintenance on a respirator (if unable to breathe adequately alone)
• Blood cultures, spinal fluid evaluations, and other diagnostic tests
• Blood transfusions

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State laws vary regarding living wills. Information specific to individual states usually may be obtained from the state bar association, state medical association, state nursing association, and most hospitals or medical centers.

A living will is not to be confused with a last will and testament that distributes assets after a person's death.

Special medical power of attorney. A legal document that allows an individual to appoint someone else (proxy) to make medical or health care decisions, in the event the individual becomes unable to make or communicate such decisions personally.

NOTE: This document provides for power to make medically related decisions only and does not give any individual power to make legal or financial decisions.

DNR (do not resuscitate) order. This states that CPR (cardiopulmonary resuscitation) is not to be performed if your breathing stops or your heart stops beating. The order may be written by the person's doctor after discussing the issue with the person (if possible), the proxy, or family.

RECOMMENDATIONS

• In the event you choose to create a living will or special medical power of attorney, know specific state laws that may apply. Write the document to be consistent with your state's laws.
• If you have a living will or special medical power of attorney, provide copies for your family members and health care providers. Carry a copy with you in a wallet, glove compartment of a car, or similar location. If you have a planned admission to a hospital, take copies for the hospital to include in your medical chart and tell all medical personnel involved with your case about the documents.
• Consider the possibilities of the future, and plan ahead. Studies have shown that although the majority of people believe having some form of advance directive is a good idea, most people have not actually developed advance directives for themselves. Many people state that they want their families to make health care decisions. However, less than half of these people have ever discussed the issue and their specific desires with family members.
• These decisions can be changed at any time. However, if a living will is changed, everyone involved -- including family or proxies and all healthcare providers -- must be informed and new copies of instructions made and distributed.