Advance Directives
Care Planning That Respects Your Wishes
Patients often have to make decisions about advance care goals, and in some cases, end-of-life care before more serious medical problems or conditions occur. Lahey Clinic's Advance Care Planning team walks you through this process so you are prepared for all outcomes.
What Is Advanced Care Planning?
Advance directives are legal instructions about the types of medical care you would want to receive in the event of a terminal illness, coma or brain damage. The directions may be oral or written, and different states have different rules, but the most common advance directives are CPR directives, durable power of attorney for health care (DPOAHC), a living will and organ donation.
Why Advanced Directives Are Important
Advance directives are important because without them, family members may be unaware of, or may misinterpret, your wishes regarding your care. It is recommended that you write down what you want to prevent confusion in managing your care and ensure your concerns are respected. This can include a wide range of instructions, including end-of-life wishes, treatment preferences and spiritual priorities.
While there are many different regulations and forms that must be dealt with when making these decisions, the overviews below can give you a general idea of why and how these advance directives are important.
- CPR directives allow you the right to refuse resuscitation if you are incapacitated. Health care facilities will attempt to revive a patient unless there are specific orders to the contrary.
- A durable power of attorney for health care (DPOAHC) is a legal document that allows you to select someone to make medical decisions for you. This representative can be helpful when your medical team and loved ones have difficulty deciding how to treat you. This person should be someone trusted to follow your instructions exactly as written in your DPOAHC.
- A living will describes the type of care you do or do not want when you are still alive but nearing death. Living wills can help your doctors and loved ones know more about what you want when it comes to your health care. These directives are a record of the care you would want but may be unable to choose for yourself due to a terminal illness or injury.
- Organ donation may become an issue if you are classified as legally brain dead. In that situation, you may or may not want your organs and tissues donated for use in transplants. Various states have different rules or forms regarding organ donor declarations. Make sure to include your wishes in your living will and inform your health care agent whether or not you want to be an organ donor.
It's important that these types of decisions are made now. Discuss what you want with your family and doctors, write it down, and make it legal. It might not always be easy to talk about, but planning your health care can help spare you and your loved ones possible difficulties in the future.
Choosing a Healthcare Proxy
Your health care proxy is the person you designate to make your care decisions if you are no longer able to. When choosing a proxy, think of someone you know who you trust to advocate on your behalf and make decisions that are aligned with your wishes. In general, consider someone who is:
- Reliable when handling personal records and complicated decisions
- Available on short notice and responsive to communications
- Understands your health care wishes inside and out
Honoring Choices
Honoring Choices provides a simple, structured approach to health care planning. Consumers and health care providers use the same tools kits and discussion guides to talk about a person’s care goals, values and choices.
You can download planning kits, discussion guides and other material to help you and your family make decisions about your care wishes. Your plan is your road map that helps your family and health care providers match the best possible care to your values and choices.
