June 25, 2014
What exactly are Healthcare Advance Directives and what is their importance? If we consult Merriam-Webster, they’re defined as: “legal document(s) signed by a competent person to provide guidance for medical and healthcare decisions in the event the person becomes incompetent to make such decisions.”
Our campus social workers are regarded as experts on the topic of advance directives, and they point out that the law does not require you to complete advance directives. The law also does not require you to have an attorney to complete an advance directive. It’s your choice, and it’s a choice that we highly encourage.
Over the years, we’ve seen time and time again how important advance directives can be. Families feel more organized and prepared when making important decisions for their loved ones if these documents are in place. Too often, families have to scramble for answers which can cause unnecessary confusion and anxiety. Taking the time to set up these documents is simple to do and definitely worth the effort.
Online at www.cancer.org, a detailed summary explains: “Advance directives can be general, with very few directions about your care. The directive may just name a substitute person (proxy [or agent]) to make these decisions for you if you are unable to do so. [They] can also be very detailed and clearly outline the different types of life-sustaining treatments you would accept or refuse in certain situations… It may help to know that you can also change or revoke (take back) these directives at any time.”
There are two main types of advance directives – the Living Will and Health Care Power of Attorney. There is also an option of a combination of the two.
- Living Wills are the oldest type of advance directives. They inform an attending physician of specific wishes related to healthcare treatment and often include whether to withhold or withdraw medical interventions if the signer is in a terminal condition. They can be as long, short, or specific as the signer wishes. These documents are important since the attending physician in an emergency situation usually will not be familiar with your or your personal wishes and values.
- A Power of Attorney for Healthcare is the other main type of health care advance directive. This document is signed and witnessed. In it, the signer designates who they would like to make health care decisions for them in the event that they are temporarily or permanently unable to make them.
Pat Tomczyk, one of our campus Social Workers for our Catered Assisted Living residents and veteran expert in this area can’t say enough about carefully selecting who you appoint as your Health Care Agent. In nearly two decades of working at Three Pillars, she’s seen many residents who have and have not had their advance directives prepared for when they were needed.
Pat offers this piece of advice: “Choose someone [as your designated Health Care Agent] who knows you very well, cares about you, and who can make difficult decisions. Sometimes a spouse or family member is not the best choice because they are too emotionally involved with you. Sometimes they are the best choice. You know best. Make sure you choose someone who is able to stand up for you so that your wishes are followed. Also, choose someone who is likely to be nearby so that they are ready to help you when you need them. Whether you choose your spouse, family member, or friend to be your Health Care Agent, make sure you talk about your wishes with this person and that he or she agrees to respect and follow them.”
Unless a person has an advance directive completed, many health care providers and institutions will make necessary critical decisions for the patient, or a court may appoint a guardian to do so. This can be worrisome since the guardian would be unfamiliar with the person’s values and wishes.
All in all, remember that advance directives are a part of a bigger process of advanced care planning. It’s about more than filling out two legal documents; it’s a process of shared decision-making by you, your family, and your health providers to improve understanding, reflection, and discussion about your future healthcare decisions. It involves conversations to clarify your values and your beliefs about future healthcare so your wishes can be honored. It’s about taking control of your future medical care, and it’s a gift to your family so they do not have to guess what kind of care you would want in a healthcare crisis. Having a plan in place helps families avoid the guilt they may feel when they do not know for sure if they’ve made the right healthcare decisions that you would want.
We encourage you to talk with your family, friends, and a legal or health care professional if you’d like more information on advance directives and their importance. The State of Wisconsin’s Health Care Power of Attorney and Living Will Declaration to Physicians can both be found online on the State of Wisconsin’s website.