Health Care Decisions for Your Future
An uncertain future can cause anyone anxiety. Caregivers often worry about making health care decisions. An important step you can take for your loved ones is deciding how your healthcare is managed if you become unable to do so.1
Advanced directives
Decisions now about how you are treated and who will decide medical care may reduce any anxiety. Advanced directives make it possible. They work together ensuring your wishes are known and carried out.
Without them, you may be given medical care you don’t want and decisions about your treatment made by someone you wouldn’t want.
A few things to keep in mind:
- Seek advice from an attorney because state laws vary. If you can’t afford a lawyer, many organizations and clinics offer low-cost or free services. I recommend avoiding do-it-yourself kits because they may not comply with state law or address your specific needs.
- Talk to your doctor to make sure you know what options are available for medical care.
- Do your decisions have religious implications? If so, talk with someone from your faith’s leadership.
- Your desires must be in writing. I encourage people to discuss their wishes with family and others, but they must be written and comply with state laws to be binding.
What are living wills?
Living wills are written documents stating the treatment you want in certain medical situations if you’re unable to express them yourself. It may state whether you do or don’t want measures like artificial breathing, artificial feeding and hydration, pain medication, long-term care, and brain death.2
It may address religious beliefs (e.g.,the administration of Last Rites by a Priest). Some states allow you to express a "Do Not Resuscitate" order, however, they don’t work well for emergencies and many states require separate documents.
Because you are making the decisions, your family, medical personnel, and others cannot override them. They’re created and tailored to your specific needs.
Health Care Power of Attorney?
The health care power of attorney (HPOA) is usually written when making a living will and is often called a "health care proxy." It names someone to make medical decisions for you.2
Living wills address many situations, but not all. The person who is granted power of attorney will have the authority to make medical decisions not addressed in your living will. Make sure to talk with the proxy.2
Are they willing and able to make decisions for you? Sometimes the decisions you or your proxy make will be different from those of family. You don’t have to choose and appoint a family member. The person you name is charged with ensuring your desires are known and carried out.
Do Not Resuscitate
Do Not Resuscitate (DNR) orders and Physician’s Medical Order for Life-Sustaining Treatment (POLST) address more immediate care. When someone is not breathing or their heart has stopped beating, medical and emergency personnel must start efforts to revive them.3,4
If someone doesn’t want aggressive measures, then a DNR or POLST ensures their desires. Unlike the documents above, both are obtained from your doctor after discussing your options for medical care.
As signed medical orders, emergency and other medical personnel must follow them and are typically limited to 1 page, printed on bright neon paper, and kept with or on you.
Medical orders
The DNR is a medical order, signed by a doctor, applying only to Cardiopulmonary Resuscitation (CPR). A DNR is like a stop sign. It tells emergency personnel and medical providers not to use CPR when breathing or the heart has stopped. A DNR doesn’t address treatments for pain, nutrition, hydration, and other end-of-life medical care.3
The POLST is a relatively new concept. Most states recognize POLSTs for life-sustaining care. Getting legal advice is essential. Unlike a DNR, a POLST often lets someone state a preference for starting or stopping CPR, other measures used (e.g. medications to start the heart), as well as life-sustaining measures.4
As a medical order, it doesn’t address concerns like long-term care, medications for pain and comfort, or religious measures like a living will.
Working in concert, advance directives express your wishes regarding care in almost every instance. Making these decisions now may give you and those you care for, peace of mind.
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