Should You Have An Advanced Directive?

In some medical situations, you may be unconscious or unable to communicate your wishes to your doctor. But there is something you can do in order to still have a voice in your care. An advanced directive is a document that states what medical treatment you want in the event you cannot speak for yourself.

Who Needs An Advanced Directive?

You may think an advanced directive is only needed for people in certain situations, but an advanced directive is a good idea for all adults. Advanced directives are not just for those with serious illness or the elderly. Unfortunately, anyone can develop a serious condition, become critically ill or sustain an injury that leaves them unable to state their medical wishes.

Without an advanced directive, your next of kin would have to make decisions for you and decide what medical care you receive. Leaving medical decisions up to family members can lead to problems. For instance, your loved ones may struggle with making the right choice. It can also lead to disputes, guilt, and stress among family members.

In certain situations, an advanced directive is especially important. For example, if a person has a terminal illness, it is helpful to have instructions, which state whether you want lifesaving measures implemented to prolong your life. Although many people may not want to think about instructions for their medical treatment if they are seriously ill, it is something that should be considered.

Components Of An Advanced Directive 

An advanced directive should contain a few different elements. One of the most important parts of the directive is delegating a durable power of attorney. This is the person you select to make sure your wishes for medical treatment are carried out. In some documents, this person may also be called your healthcare agent.  It can be a family member, friend or anyone you choose.

The most important thing to consider when selecting a durable power of attorney is to choose a person you trust who will carry out your wishes. Remember this is the person who will speak for you if you cannot. Before you list a certain individual as your healthcare agent, speak to them about your wishes and make sure they are comfortable with their role.

Give careful consideration to what you would and would not want done in certain medical situations. There are several things to consider, such as whether you would want to undergo resuscitation if your heart stops or you stop breathing. In an advanced directive, instructions may also include whether you would want to be placed on a mechanical ventilator if you needed breathing assistance. 

See Also: Don't Spoil The Ending: How To Talk About And Plan For Terminal Illness

Other considerations when writing an advanced directive include instructions on aggressive measures if your conditions required it including a feeding tube, blood transfusions or dialysis. In addition, an advanced directive can state if you want to be an organ donor or have your body donated to science after your passing.

What You Should Know About Writing Your Advanced Directive

Medical terminology can be complex. Understanding your options regarding medical treatment is essential when writing your advanced directive. A misunderstanding about what certain medical care means may prevent you from choosing what is right for you. 

What Is Code Status?

One of the most common healthcare instructions in an advanced directive is code status. Code status refers to whether you want certain interventions implemented in a life-threatening situation, such as if you had a cardiac arrest. Further explanation of code status includes:  

Full Code: A full code involves all measures necessarily to try to save a person’s life. It includes procedures, such as CPR, administration of medication, and defibrillation. In may also involve insertion of a breathing tube to assist with ventilation and the assistance of a mechanical ventilator.  

Limited Code: People who are a limited code only agree to some resuscitation procedures. A limited code can mean different things to different people. If you choose a limited code status, you need to state which procedures you want. For example, you may agree to medication and CPR, but not want to be placed on a mechanical ventilator.   

Do Not Resuscitate: If you do not want any lifesaving interventions, such as CPR, mechanical ventilation or medications, your instructions should include a do not resuscitate code status (DNR). Keep in mind, making yourself a DNR does not mean you will not receive treatment. Pain medication and other treatment will still be provided.

Advanced Directives Considerations

Before you write an advanced directive, there are several things to take into consideration. For starters, if there is something you don’t understand about medical treatment or care, ask your physician.

Whether you want to change code status, healthcare instructions or your power of attorney, you have the right to do so whenever you wish.

It is also a good idea to discuss your advanced directive with family members.  Family members may sometimes have different ideas on what is appropriate for their loved one. For example, it can be difficult to accept a loved one does not want lifesaving measures implemented if their heart stops. Letting your loved ones know about your advanced directive keeps everyone on the same page. 

When it comes to the legal aspects of the directive, there is not one specific form, which must be used. You can seek the assistance of a lawyer or write it yourself. There are also many organizations, which can help you draw up an advanced directive if you are unsure of how to do it.

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Keep in mind, writing an advanced directive is a very personal decision, which you need to give a lot of thought. Lots of factors go into an advanced direction. Your health, age and personal beliefs all play a part in deciding what is best for you. Even if family members do not agree with your decisions, never allow yourself to be pressured regarding any aspect of your advanced directive.