• By Karl Oestreich

Plan ahead with an advance directive for medical care decisions

June 17, 2020
a middled-aged man helping an older woman with something on the screen of a laptop

While you never hope to use one, an advance directive outlines your preferences for medical care if you become ill and are unable to make decisions for yourself.

An advance directive is a legal document that you can complete at any time. It allows you to decide what kind of medical care you want in case you become too ill or hurt to express your wishes. Spelling out decisions about end-of-life care ahead of time can avoid confusion later on among loved ones. An advance directive also informs your health care team about who you want to speak for you — often called a health care power of attorney or health care agent — and what you would want, or not want, in a difficult situation.

Mei Yeow, B.M.B.Ch., Palliative Medicine, explains that many people associate advance directives with decisions to stop treatment, when in fact patients may direct their physicians to continue aggressive treatments if that is their wish.

"An advance directive empowers patients to define their choices about end-of-life care, which enables the medical team to continue to provide patient-centered care," says Dr. Yeow. "I encourage everyone, particularly any patient with a serious illness, to make time to have these meaningful conversations with loved ones, complete an advance directive and ask your family members to do the same."

Advance directives can be in the form of a living will, designation of health care surrogate or other document naming an alternate decision-maker.

Complete or review an advance directive

Dr. Yeow recommends that regardless of your age or current state of health, if you're over 18, it's important to set up an advance directive. To get started:

  • Talk to your loved ones about these issues
  • Decide who you want to speak for you if you're unable to make decisions for yourself and make sure they're informed about what you want
  • Talk with your medical provider to understand the various choices or treatment options that might arise in the end-of-life setting
  • Fill out an advance directive form
  • Depending on where you live, the form may need to be signed by a witness or notarized
  • Give your advance directive to your health care professional to be added to your medical record
  • Be sure your family members have a copy so it can be easily accessed at any time

Links to state-specific forms can be found on the websites of various organizations such as the American Bar Association, the American Association of Retired Persons (AARP) and the National Hospice and Palliative Care Organization. An advance directive can also be revised at any time you wish.

Learn more about advance directives and living wills on the Mayo Clinic website.

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