The Documents You Need: Advance Directive

Next in my series of posts about the documents you need is the advance directive. This basic document ensures that your wishes will be carried out if you become unable to make your own healthcare decisions. Although the documents have been available for years, they entered the mainstream during the Terry Schiavo case. If you don’t have one, you need one. They’re easy to complete and you can do it free.

How an Advance Directive Works

An advance directive is actually two documents: a living will and a power of attorney for health care. The living will states your wishes should be unable to make your own medical decisions. The power of attorney for health care names the agent authorized to make your decisions and grants them the authority to do so. In most cases, the directive comes into force if you’re unconscious, but it can also apply if you suffer dementia or are otherwise unable to make decisions for yourself. The authorized person can make decisions for you, within the bounds of your stated wishes.

The living will covers most forms of treatment, and allows you to decide in advance whether you would like your life prolonged or not. In addition, you can specify other aspects of your care. The California directive includes a specific form related to your decisions about dementia treatment. You should avoid making your wishes too limited because it could limit the ability of your doctors to care for you. Common decisions include:

  • Use of antibiotics
  • Provision of food or water
  • Dialysis
  • Blood transfusion
  • Artificial ventilation

You can change or revoke your living will and proxy at any time.

How to Create an Advance Directive

If you used a lawyer to create a will or trust, then a living will was probably included in the service. If you don’t have a will or didn’t use a lawyer, you can create an advance directive for free by visiting Compassion & Choices. Simply complete the request and you’ll receive an email with a link to download the form for your state. Review the instructions, and then complete the form. In California, you can either have it notarized or sign it in the presence of two witnesses. At least one witness must be a non-relative.

Before choosing your authorized agent, you should discuss your wishes with them and ask their permission. Most people designate a spouse, but you can designate a parent, adult child, unmarried partner, or even a very good friend. Before I was married, my parents were my authorized agents, and then I completed a new form designating my spouse after we were married.

If you move to a new state, you should complete a new directive because each state has its own requirements. If you’re not married, you should see if there is an additional form for unmarried partners.

Where to Keep Your Living Will

Like your will, you shouldn’t keep the advance directive in a safe deposit box except as a back-up copy. You should keep one copy in your home with your will and other documents. Your primary agent should receive a copy. You may also give a copy to your lawyer or doctor. If you’re entering the hospital for surgery or extended care, you should ask to file a copy with your records to ensure that your requests are met.

Tomorrow the series continues with a discussion of the necessary insurance policies.

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