Advanced care directives

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Medical power of attorney

Advanced care directives are specific instructions, prepared in advance, that are intended to direct a person's medical care if he or she becomes unable to do so in the future.

Power of attorney; DNR; Do not resuscitate; Living will

Advanced care directives allow patients to make their own decisions regarding the care they would prefer to receive if they develop a terminal illness or a life-threatening injury. Advanced care directives can also designate someone the patient trusts to make decisions about medical care, if the patient becomes unable to make (or communicate) these decisions.

Federal law requires hospitals, nursing homes, and other institutions that receive Medicare or Medicaid funds to provide written information regarding advanced care directives to all patients upon admission.

Advanced care directives can reduce:

• Personal worry
• Futile, costly, specialized interventions that a patient may not want
• Overall health care costs
• Feelings of helplessness and guilt for family
• Legal concerns for everyone involved

However, advanced care directives cannot predict what situations may arise in the future or what new modes of care may be available for situations considered nearly hopeless today.

EXAMPLES OF ADVANCE DIRECTIVES

Verbal instructions. These are any decisions regarding care that are communicated verbally by an individual to health care providers and family members.

Organ donation. This may be accomplished by completing an organ donation card and carrying it in your wallet. A second card may be placed with important papers (such as a living will, insurance papers, and so on). Most hospitals or other major health care centers have organ donor information available.

Many states offer people who are applying for new or renewed driver's license the opportunity to make a decision regarding organ donation and have it recorded on the driver's license. More information may be obtained by calling 1-800-24-DONOR.

Living will. This is a written, legal document that conveys the wishes of a person in the event of terminal illness. This document can speak for a patient who is unable to communicate. A living will may indicate specific care or treatment the person does or does not want performed under specific circumstances. This may include specific procedures, care, or treatments such as the following: