Talking about end-of-life issues can be difficult for anyone. Often the best way to address the subject is to begin the conversation with sharing views about values, spiritual beliefs, and desires related to what makes life worth living for each individual. These conversations may also be stimulated after the loss of another family member or friend. Those who cannot have actual conversations may still share their desires in letters to loved ones. Learning about another’s wishes is invaluable in meeting their desires when they can no longer express their needs.
Everyone should take the initiative to make their own decisions while they are able to as leaving others to make these decisions for you may not result in choices that you would made or may cause much dissent within your family. Sharing your decisions with your loved ones, your attorney and your doctor is also very crucial to having your wishes respected.
These decisions should be reevaluated and altered over time if circumstances change. Advance directives do not expire. They remains in effect until the individual changes it.
An Advance directive, living will, personal directive, or advance decision are all terms used to mean the same thing; they are simply written instructions to communicate one’s wishes and/or to appoint someone to speak for them when they are no longer able to due to illness or incapacity. A living will can be as simple as naming someone to make medical decisions in your behalf or written as; “If I suffer an incurable, irreversible illness, disease or condition and my attending physician determines that my condition is terminal, I direct that life-sustaining measures that would serve only to prolong my dying be withheld or discontinued” or can become very complicated addressing every single wish. Advance directives should provide specific directives regarding such issues as : where the individual wishes to reside if terminally ill, if intravenous fluids or artificial nutrition is desired, if life support equipment such as a ventilator is wanted, if life support is to be discontinued if brain death has occurred, if CPR is desired, if antibiotics for infections or pain relief is desired?
Advance directives have increased in popularity with 30-40% of Americans having them in place.
They only are effective if 2 physicians certify that the individual is unable to make medical decisions as per individual state law.
Advance directives are legal in every state but the laws of each state may vary so it is important to comply with your state of residence.
You do not need an attorney to complete an advance directive, it becomes a legal document as soon as it is signed in front of the required witnesses. Family members, heirs and medical providers cannot be witnesses.
Living wills have nothing to do with an individual’s personal possessions.
A medical power of attorney, durable power of attorney (DPOA), a healthcare agent or health care proxy are all terms used to identify the person appointed by the individual to speak for them if it is deemed that the individual is unable to make their own medical decisions. It is usually a part of an advanced directive.
The choice of a healthcare agent must be wisely made to ensure that the decisions are followed as the agent will have the legal authority to speak for the individual regarding health care decisions only. This person will have the legal right to make decisions regarding treatment for the individual as if they were still capable of making and communicating health care choices even if family members disagree. Some will also appoint a second individual in case the first would not be available to make decisions. The agent cannot make decisions if the individual regain the ability to make their own decisions.
You MUST discuss your wishes with the person(s) you have chosen to speak for you.
Templates for these documents can be purchased, local hospitals should also have forms or one may write a letter in their own words. Many individuals will have a combination of living will and health care proxy. Once these decisions are made and the paperwork is completed give copies to family members, your doctor, your attorney and health care proxy. Documents must be easily located in time of need.
Once again it is important to follow the laws of the state you reside in. If you reside in different states, you must make sure that your decisions are legally correct by each state’s laws. More information can be obtained at http://www.caringinfo.org/index for state specific details.
It is important to be aware that out-of-hospital emergency personnel (EMT’s, paramedics) cannot legally honor living wills or medical powers of attorney. Some states have specific forms for out-of-hospital resuscitation efforts. Once the individual is evaluated by a physician, advance directives can be implemented.
Other important decisions:
Power of attorney (POA), letter of attorney in common law systems or mandate in civil law systems is an authorization to act in another’s behalf in a property or financial matter not health related matters.
A will or testament is a legal declaration by which a person names one or more persons to manage their estate and provide for the transfer of property at death. Any person of legal age and sound mind can draft their own will with or without the aid of an attorney.
Planning funeral services, memorials, life celebrations has become increasingly popular. Individuals can plan and finance their own funerals, memorial services, or life celebrations before they die. This ensures that their desires are met and removes the emotional and financial burden for the family.
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