What's an Advance Directive?
Advance directives are legal documents that spell out your parents' wishes regarding future medical care and treatment. It is based on two major principles of law: A person has the right to accept or refuse treatment (informed consent), and a person has the right to appoint someone to act on his or her behalf. Advance directives are in effect immediately and—most importantly—when the maker of the advance directive (your parent) is no longer able to make decisions for him- or herself.
Advance directive is actually a general term. There are two types of advance directives: a living will and durable health care power of attorney. Let's take a closer look at each one.
A living will is a type of advance directive in which your mom states her wishes as to whether or not she wants medical treatment that will prolong her life should she become terminally ill or injured, or permanently unconscious. The living will takes effect when a doctor determines that death is fairly certain or that the person is in a persistent vegetative state with virtually no hope of recovery. The document tells the doctors, hospital, and other health care providers exactly what your mom wants to have done or not.
Every state has its own law regulating living wills. Most states have adopted specific living will forms for you to use. States also identify under what conditions the living will is considered valid. Since state laws can change at any time, it's important that you use a current form and become aware of your own state's laws surrounding this kind of advance directive.
If your parent (or you) is interested in writing a living will, here are two excellent resources:
- Aging with Dignity, a nonprofit organization dedicated to promoting better care of the dying and human dignity, offers a terrific Five Wishes advance directive that serves as both a living will and durable health care power of attorney. You can view a copy on that organizations Web site (www.agingwithdignity.org) and have it mailed to you. This form has been accepted by 33 states, which are identified on the form. It's very easy to understand. Contact Aging with Dignity, P.O. Box 1661, Tallahassee, Florida 32302; 1-800-562-1931.
- Choice in Dying, Inc., a nonprofit organization, fosters communication about complex end-of-life decisions. They provide advance directives, counsel patients and families, train professionals, and act as advocates for improved laws. At their excellent Web site (www.choices.org) you can download each state's living will forms, keep current on end-of-life issues, and track down related resources. Contact Choice in Dying, Inc., 1035 30th Street, NW, Washington, D.C. 20007; 1-800-989-9455.
A living will is worthless if it's secretly stored away in a safety deposit box. Here's who should get copies: your parents' primary family physician and specialists, you and other family members, the person who is their agent (an individual chosen by your parents to make health care decisions on their behalf should they become incompetent), the hospital that they would be taken to an emergency, and any nursing home they are admitted to. If they are very active in their church or synagogue, share a copy with the priest, minister, or rabbi. Always take a copy of the form whenever your parent is being treated at a health care facility (such as an outpatient surgery center).
Most living wills have statements that release doctors from any legal liability for withholding medical treatment that would prolong the patient's life. As you can imagine, doctors and hospitals fear lawsuits from family members who charge they haven't done everything possible to save a life. If your parent doesn't have a living will, doctors will go full swing into, a lifesaving mode, as you see in the TV show ER.
Your parent must face one central question: “How much medical intervention do I want to keep me alive when death is certain?” There are a number of responses to that question.
More on: Aging Parents
Excerpted from The Complete Idiot's Guide to Caring for Aging Parents © 2001 by Linda Colvin Rhodes, Ed.D. All rights reserved including the right of reproduction in whole or in part in any form. Used by arrangement with Alpha Books, a member of Penguin Group (USA) Inc.
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