Understanding Advance Directives

An Advance Directive is a legal document that allows individuals to plan and communicate their medical treatment preferences in the event that they become unable to make decisions for themselves. These documents provide a way for people to express their wishes regarding their medical care, including the type of treatment they would like to receive or not receive, in the case of a serious illness, injury, or end-of-life situation.  

Advance Directives are an important tool for ensuring that an individual's values, beliefs, and wishes are respected, even if they cannot speak for themselves. They can provide peace of mind for the individual, their family, and their healthcare providers, by clarifying the person's preferences and reducing the risk of misunderstandings or conflicts.

There are several types of Advance Directives most commonly used. These include a Living Will, Durable Power of Attorney for Health Care (Health Care Proxy), and a Do Not Resuscitate (DNR) Order. Some less commonly used Advance Directives include a Mental Health Advance Directive, and finally a Five Wishes Document. Let’s explore these different types of Advance Directives further.

• Living Will: A document specifying the medical treatments you would like to receive or not receive in the event you become unable to make decisions about your own medical care. This is the most commonly discussed advance directive. This basically allows you to capture your wishes in a document. However, it certainly can’t contemplate every possible scenario. So, you may want to also have someone you trust be able to assist in the decision making process. This is where the Health Care Proxy comes in.
• Durable Power of Attorney for Health Care (Health Care Proxy): A legal document that appoints someone you trust to make medical decisions on your behalf in the event you become unable to do so. This document allows you to entrust someone else with making decisions on your behalf. Certainly, this would be someone you trust, and someone you believe well understands your desires in these situations. Naturally, this person would also be guided by any other written directives you have provided.
• Do Not Resuscitate (DNR) Order: A medical order specifying that cardiopulmonary resuscitation (CPR) should not be performed if your heart stops or if you stop breathing. DNR’s are very common. These are most often created by either people that are advancing in age, and/or know they have a terminal disease. Many people do not want to put themselves, or their family, through an advanced life saving procedure that will only prolong the inevitable. 
• Mental Health Advance Directive: A document specifying the types of mental health treatment you would like to receive or not receive in the event you become unable to make decisions about your own mental health care. Having a Mental Health Advance Directive is particularly important for individuals with a history of mental illness, as it helps ensure that their rights and autonomy are respected, even if they are unable to make decisions for themselves. It can also provide peace of mind for family members and healthcare providers, who are better equipped to provide appropriate care in line with the individual's expressed wishes.
• Five Wishes Document: A comprehensive advance directive that covers medical, personal, emotional, and spiritual needs and wishes. The Five Wishes Advance Directive is recognized in 42 states as a legally binding document (but it is useful in all 50 states), and it is designed to be a living document that can be updated and revised over time to reflect changes in the individual's health and life circumstances.

You may be wondering, do I need a lawyer to create a legal Advance Directive? You do not necessarily need a lawyer to create an Advance Directive. While it is possible to work with a lawyer to draft your Advance Directive, many states provide free or low-cost Advance Directive forms that you can fill out and sign on your own, or with the help of a trusted friend or family member. Some states also allow you to create an Advance Directive using an online tool or software.

Advance Directives play a crucial role in safeguarding your healthcare wishes and ensuring that they are honored in the event you become unable to make decisions for yourself. Complementing your estate planning documents, such as a will or trust, Advance Directives serve to provide guidance and direction for your medical care, even in circumstances where you may not be able to communicate your wishes. By appointing a Health Care Proxy and documenting your preferences through Advance Directive documents, you can empower a trusted individual to act on your behalf and make decisions in line with your values, beliefs, and priorities. In this way, Advance Directives serve as an essential component of your estate planning process, providing peace of mind and ensuring that your health and well-being are respected throughout all stages of your life.