Decision-making made easier in times of emergency
An accident; a stroke; an acute or chronic illness: These situations and countless others can leave you unable to express your health care wishes. How can you make your desires and decisions known when you cannot speak for yourself?
That’s where advance care directives come in. These simple but important documents help both medical professionals and your loved ones know what you want and what to do in times of crisis.
WHY SHOULD I HAVE AN ADVANCE CARE DIRECTIVE?
Advance care directives are much more than just telling loved ones your health care wishes: They are written, legally recognized instructions outlining preferences for medical care if and when you are unable to make decisions for yourself, especially when you are in danger of dying. These directives typically include:
- A designated health agent proxy empowered to make decisions about your health care, as well as all current contact information.
- Health care goals, values, and preferences.
- The types of medical treatment wanted or not wanted.
- Where care is received, such as a hospital or at home.
- Instructions about treatments such as artificial nutrition and hydration, CPR, dialysis, and end-of-life medical care.
While there are many versions of advance care directive forms available, the California Office of the Attorney General offers an all-in-one free, fillable form that covers all major care directive components. All an advance care directive needs to be considered legally official is either the signatures of two people who are not named as agents or proxies in the document, or the signature of a notary public.
When you have completed an advance care directive, it’s key to:
- Keep the originals in a safe but easy-to-find place.
- Give a copy to a doctor.
- Give a copy to the designated health care agent and any alternate agents named in the directive.
- Keep a record of who has copies of the directive.
- Talk to family members and other important people about your wishes and what you’ve documented in your directive.
- Carry a wallet-sized card—like this free card provided by the American Hospital Association—saying you have an advance directive, identifying a health care agent and his or her related contact information, and stating where a copy of the directives can be found.
- Have a copy when traveling.
Once you have an advance care directive, don’t forget to update it to reflect your changing needs and values. The American Bar Association recommends reviewing and updating advance care directives when any of the five “Ds” occur: when you reach a new decade in age; you experience the death of a loved one; you divorce; you are given a diagnosis of a significant medical condition; you suffer a decline in your medical condition or functioning.
According to the Kaiser Family Foundation, 97% percent of people taking part in a 2017 survey said it’s important to put their health care wishes in writing in case of an emergency, but only 37% have actually done so. However, the benefits of having an advance care directive can be enormous:
- Yourself—Having health care wishes in writing can help avoid unnecessary pain, unhelpful or undesired procedures, and unwanted hospitalization.
- Your loved ones—Written instructions give loved ones clarity and direction, minimize stress, and reduce potential conflicts among family members.
- Medical professionals—Advance care directives provide valuable personal insight on treatments that would normally be verbalized.
Advance care directives all start with a conversation about health care wishes with loved ones … and even with yourself. It’s often a hard talk to have, but vitally important. For help thinking and talking about what is wanted in an advance care directive, several resources are available, including:
- The Conversation Project—This public-engagement initiative offers a free conversation-starter kit in more than a dozen languages.
- Go Wish—The Coda Alliance has created a card game featuring questions about players’ advance and end-of-life care wishes; the card game is available in seven languages, and a free interactive English version is available online.
- The National Institutes of Health/National Institute on Aging (NIA)—NIA offers general FAQs on advance care directives.
California Department of Consumer Affairs licensees are also valuable resources: Licensees of the Professional Fiduciaries Bureau can assist with or oversee advance care directives and end-of-life planning, and your primary-care doctor and other DCA-licensed health care professionals can help answer your questions about advance care directives and associated medical treatments.
With helpful resources at hand, an advance care directive can give you and loved ones peace of mind in times of crisis.