What is an Advance Directive?
So, what is it?
An advance directive is a written legal document that explains your choices for medical care if you get too sick or hurt to speak for yourself. Creepy, right?
Basically, if you’re seriously injured or unconscious, suffering from dementia, or otherwise unable to advocate for yourself in the moment, an advance directive provides the doctors with clear guidance on how to treat you.
Just thinking about needing to make these decisions is enough to make anyone want to close this article and go back to being happy and naive.
As much as we don't like thinking about these situations, this is one document I believe every adult should consider.
Think about it. We all take getting in our car and running errands or going to work for granted. Did you know that statistically, over 20% of car crashes happen within a mile of your home? We all get comfortable, let our guard down a little. That’s human and extremely common. But with that comes a sort of complacency that can be shattered in an instant.
If that were to happen to you, who knows your wishes? I’m not talking about the in passing, “Oh gosh, if that ever happens to me, just pull the plug” kind of comment. I’m talking about a serious discussion with your trusted people. One where you get very specific and uncomfortable with one another…in the most loving way possible, of course.
An advance directive can be a guide in dark times.
When there's no direction, loved ones are often left making impossible decisions without knowing what you would have wanted. An advance directive helps solve that problem, allowing you to breathe and feel all your feelings without worrying about what your loved one wants, because you’ll already know.
While each state, territory, and country has their own version of an advance directive, here are the basic building blocks.
One of the most important decisions you get to make is naming the person who will make medical decisions for you. This can be known as a healthcare proxy, healthcare agent, or medical power of attorney. Who should this be?
Someone who:
Clearly understands your wishes and is committed to ensuring they are honored, even if others disagree
Can remain calm, even in tense or chaotic situations
Is comfortable speaking with healthcare professionals
It doesn’t have to be family, either. It can be anyone you want.
It may not be the person you’re closest to.
It will be the person you trust most to carry out your wishes.
Your voice gets to be heard by documenting your healthcare preferences
Many times, an advance directive will include a living will.
Despite its name, a living will has nothing to do with Ronny getting your baseball card collection or Aunt Edna leaving her estate to the local animal shelter.
What it does is allow you to document your preferences for healthcare treatment.
Depending on where you live, you may be able to provide guidance when it comes to:
If you want to be put on a ventilator or not
Whether you’d like to donate organs and tissue
How you want your pain managed
Any life-sustaining treatment, if any
Are you in or out on artificial nutrition and/or hydration?
End-of-life care preferences
You won’t be able to predict every possible medical situation, that’s not the goal.
The goal is to offer guidance so the medical staff and your family aren’t left guessing.
Most importantly, the choice of how you want to die is yours.
Many advance directives will allow you to record your wishes regarding end-of-life care.
For example:
Do you want resuscitation efforts? In some places you can get even more detailed as to how long you’d want the team to try and revive you or what, if any medications they can administer.
If there’s nothing medically left to try and save you, you can say what kind of comfort-care you desire.
If you’re terminal, you can specify if you’d like hospice care
The family-dreaded Do Not Resuscitate (DNR) orders, where applicable. Always let your medical team know if you want to be allowed to follow the light…or whatever comes next.
Something important to note: a DNR is often a separate medical order. Because apparently nobody has ever accused paperwork of being easy.
Because requirements vary by state, country, and territory it’s important to review the specific rules where you reside.
Why an Advance Directive matters
Without one, your loved ones are often forced to make incredibly scary decisions in a time where there is no way they can think straight.
Even if your family always seems to agree, medical situations can sometimes make strangers of us all. Dad believes you’d want to stay on life support, hoping for a miracle. Your sister remembers you saying you never wanted to be kept alive without a reasonable chance of recovery.
An advance directive won’t ease the grief your family is experiencing.
It doesn’t make impossible situations any easier to navigate.
But it can remove uncertainty.
Instead of wondering what you would have wanted, your loved ones will have documentation to reflect your wishes.
That kind of clarity can be an incredible gift.
Is there an age limit on getting one?
For the longest time I thought you had to be within social security receiving age or terminally ill to create an advance directive.
Turns out, every adult should have one.
Medical emergencies can happen at any time, and incapacity doesn’t only affect older adults.
Creating an advance directive before a crisis allows you the time to think carefully about what you want, discuss it with your favorite people, and have everything in writing.
A few things to remember
Advance directives are legal documents. This means their requirements vary by state, territory, and country.
Don’t forget it exists. With time and age your wishes might change. Take the time to review and update periodically.
Keep it someplace safe, but accessible. Think purse, wallet, backpack, etc. where it can be accessed easily in an emergency.
Make sure your family, healthcare providers, and healthcare agent all have copies.
Make sure you talk about your wishes with the people who will be asked to make these choices in an emergency situation.
A document is helpful.
A conversation is even better.
Not Legal Advice
This article is intended for educational purposes only and does not constitute legal, medical, or professional advice. Because laws vary by state, territory, and country please consult qualified legal and healthcare professionals regarding your specific circumstances.
