What is an Advance Directive?

An advance directive, also known as personal directive, advance healthcare directive, medical directive or advance decision, is a legal document which allows a person to choose and define what actions should be taken regarding their health if they are no longer able to communicate due to illness or incapacity. When you complete an advance directive, you are communicating your wishes to your family and friends, and your healthcare providers. An advance directive helps avoid confusion and conflict over your future care, especially if there comes a time when you cannot express your wishes yourself. These are tough decisions to make and may be very uncomfortable to think about, but avoiding them now will make things much harder for yourself and your loved ones later-on.

Advance directive is the general term that refers to various documents that usually include a living will/instruction directive and a healthcare proxy/healthcare power of attorney. It’s important to remember that you can make any changes you want to these documents at any time. You can change your wishes or name someone else as your healthcare proxy whenever you would like. Laws surrounding advance directives, living wills, healthcare proxies and other parts of advance planning vary from state to state. You do not require a lawyer to create an advance directive, but if you have any questions, they should be answered by a lawyer.

What is a living will?

The living will was the first form of advance directive ever proposed. In 1969 it was proposed as a way for an individual to express his or her healthcare desires when they are no longer able to communicate them presently. Because this form of “will” was to be used while an individual was still alive (but no longer able to speak for themselves) it was named the “living will.” A living will provides instructions to healthcare providers and caregivers to follow regarding medical treatment. It may prohibit certain burdensome treatments. A living will may also be used to express the wishes of accepting or rejecting food or water, if supplied artificially by tubes or other medical devices. Living wills are only used when a person is unable to give consent or refusal due to incapacity. An example of a statement you may find in a living will is: “If I suffer an incurable, irreversible illness, disease, or condition and my attending physician determines that my condition is terminal, I direct that life-sustaining measures that would serve only to prolong my dying be withheld or discontinued.” Living wills reflect a moment in time when they are completed and therefore may require regular updating to ensure that your current wishes are upheld.

What is a Healthcare Proxy?

Most living wills are limited in scope and may fail to fully address problems and needs in the event that a patient becomes incapacitated. Because a living will may be insufficient by itself in addressing important healthcare decisions, you are encouraged to also complete a healthcare proxy appointment. These documents allow an individual to appoint another person to make healthcare decisions on their behalf if they are ever incapable of making their wishes known. This appointed healthcare proxy is essentially granted the same rights to request or refuse treatment that the patient would have if still capable of making their own healthcare decisions. The most notable benefit of having a healthcare proxy is that they are able to make decisions in real-time as actual circumstances arise, whereas the living will is framed in hypothetical situations.

The Five Wishes

Another option available to people is the Five Wishes document. There are nearly 30 million people using this document right now and it has been translated into 28 different languages. It meets statutory criteria in 42 states. It is unique in that it takes a holistic approach to advance planning by addressing a person’s medical, personal, emotional and spiritual needs as well as their comfort and care choices. The Five Wishes document is broken down as follows:

Wish 1: The Person I want to Make Care Decisions for Me When I Can’t (assigning your healthcare proxy)

Wish 2: The Kind of Medical Treatment I Want or Don’t Want (your living will)

Wish 3: How Comfortable I Want to Be (pain management, personal grooming and bathing instructions, amongst other things are addressed in this section)

Wish 4: How I Want People to Treat Me (topics such as if you would like to be kept at home and if it is okay for people to pray at your beside are addressed in this section)

Wish 5: What I Want My Loved Ones to Know (this section deals with forgiveness, how you would like to be remembered and final wishes for funeral/memorial plans)

The Importance of End of Life Planning

End of life planning can be difficult, but it is one of the greatest gifts that you can give yourself and your family. When decision-making is placed on families when a loved one is actively dying or after they have passed, it can lead to so much unnecessary strife. This is a time for family and friends to support one another and grieve. When everyone is made aware of that person’s wishes and there is a designated healthcare proxy, it alleviates the guess work. It relieves a lot of tension.

Doulagivers Care Consultants

Unfortunately, many people don’t know how to do this on their own. The International Doulagivers Institute offers a course so that you can become a professional in end of life planning and help individuals ensure that their wishes are known and honored ahead of time. Doulagivers Care Consultants are trained to help individuals create a personal plan for the future, which includes their advance directive, a living plan, and even family mediation.

If you think you may be interested in an end of life planning career, The Doulagivers Care Consultant course may be for you. For more information, visit The International Doulagivers Institute website here

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A person that is passionate about reshaping the way we view and handle end of life as a society.

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