Making Your Advance Care Wishes Known

There are main elements in an advance directive: a living will and a durable power of attorney for health care. There are also other documents that can supplement your advance directive. You can choose which documents to create, depending on how you want decisions to be made. These documents include:

  • Living Will
  • Durable power of attorney for health care
  • Other advance care planning documents

Living Will: A living will is a written document that helps you tell doctors how you want to be treated if you are dying or permanently unconscious and cannot make your own decisions about emergency treatment. In a living will, you can say which of the procedures described in the decisions that could come up in the section you would want, which ones you wouldn’t want, and under which conditions each of your choices applies.

Durable Power of attorney for health care: A durable power of attorney for health care is a legal document that gives another person the authority to make medical decisions for you at times when you are unable to do so. The person named to represent the individual is referred to as an agent, proxy, or attorney-in-fact. They should be familiar with your values and wishes. This means that he or she will be able to decide as you would when treatment decisions need to be made.

Other advance care planning documents: You must also want to prepare the document to express your wishes about a single medical issue or something not already covered in your advance directive.

Medical issues that might arise at the end of life include:

  • DNR orders
  • Organs and tissue donation
  • POLST and MOLST forms

A DNR (Do Not Resuscitate) order tells medical staff in a hospital or nursing facility that you do not want them to try to return your heart to a normal rhythm if it stops or is beating unsustainably using CPR or other life-support measures. Sometimes this document is referred to as a DNAR (Do Not Attempt Resuscitation) or an AND (Allow Natural Death) order. Even though a living will might say CPR is not wanted, it is helpful to have a DNR order as part of your medical file if you go to a hospital.

A non-hospital DNR order will alert emergency medical personnel to your wishes regarding measures to restore your heartbeat or breathing if you are not in the hospital.

POLST and MOLST forms provide guidance about your medical care preferences in the form of doctor’s orders. Typically, you create a POLST (Physician Orders for Life-Sustaining Treatment) or MOLST (Medical Orders for Life-Sustaining Treatment) when you are near the end of life or critically ill and know the specific decisions that might need to be made on your behalf. These forms serve as a medical order in addition to your advance directive.