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What You Should Know About Advance Directives What You Should Know About Advance Directives
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Why You Need Advance Directives

Insights & Ideas Team •  August 25, 2015 | Home and Family

It’s a common hope that most people share: that their end-of-life wishes will be respected if something happened and they couldn’t make their own health care decisions. Yet only about a third of Americans age 18 or older have signed advance directives to ensure their preferences will be honored, according to a study published in the American Journal of Preventive Medicine (January 2014).

What were the reasons people failed to complete these important documents? Some of the study respondents said they didn’t know about advance directives (about 25 percent); others felt they were too young or healthy to need one.

Of course, no one wants to think about what could happen if he or she became incapacitated due to a life-threatening illness or injury. But advance directives, including a durable power of attorney for health care and a living will, can help ensure your health care wishes are known at a time when you may not be able to make decisions for yourself, says Jennifer Jedrzejewski, director of advanced planning, for Northwestern Mutual. “Discussing your wishes with your loved ones and preparing advance directives offers the best assurance that any decisions regarding your future medical care will reflect your own values and desires.”

An advance directive is a generic term for a document that instructs others about your medical care should you become unable to make decisions on your own. Generally, it refers to two separate documents: a living will and a power of attorney for health care (also called a health care proxy or medical power of attorney). “Don’t confuse a medical power of attorney with a living will,” cautions Jedrzejewski. “They serve very different purposes.”

A living will tells medical professionals and your family which end-of-life medical treatments (for example, life support, CPR, feeding tubes and pain management) you want to receive, which you’d like to forgo and under what conditions. In contrast, a health care power of attorney allows you to appoint someone (generally referred to as your “agent”) to make health care decisions for you any time you’re unable to do so. Many people select a family member or trusted friend to act as an agent. Whomever you select, just be sure you talk with this person to make sure he or she understands and is willing to accept this responsibility.

Jedrzejewski recommends completing advance directives starting at age 18. “Many people think advance directives are for older people, but you can have a devastating accident or face an incurable illness at any age. If you don’t have advance directives in place, your family may have to guess what you’d want them to do, and they would have to go to court to be appointed to make decisions on your behalf. Such a situation can create conflict and stress if some family members or loved ones aren’t in agreement about your treatment plan.”

How do you prepare an advance directive? You can download free state-specific forms online from a number of sources, including your local hospital, state health care association, and the AARP; or you can speak with an attorney. While you’re not required to seek legal advice to prepare advance directives, Jedrzejewski believes it often makes sense to do so. “Every state has its own laws regarding health care proxies. Working with an attorney can help ensure the documents you create accurately reflect your wishes and comply with state law. Advance directives must comply with state law to be enforceable.”

Whichever way you do decide to go, you may want to speak with your loved ones before signing your advance directives. Helping them to understand your intentions can ensure your wishes will be honored—even if they are different from your family members’ beliefs. Once you sign your documents, you should give a copy to a trusted family member and/or friend, as well as to your physicians. If you are admitted to a hospital or nursing home, you’ll also want to give a copy to the attending physician and/or floor nurse. And finally, keep a copy of your advanced directives in a safety deposit box and in an accessible place in your house. Then tell family members where they can find them should the need arise.

Don’t feel you can’t change your mind once your documents are signed. “It’s not uncommon for people to change their opinions about how they want their future health care needs to be met,” says Jedrzejewski. “Directives can be revoked or revised, and you can replace your agent at any time as long as you are capable of making your own decisions. It makes sense to review your documents periodically, or after important life changes, to make sure they continue to reflect your situation and wishes.”

Planning for the unknown is never easy, but it’s a gift to your loved ones—and to yourself. With advance directives in place, you can be assured that your wishes will be honored no matter what.

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