Have you considered what medical measures you would like to have performed should you be in a life-threatening situation? What would happen if you were unable to communicate these expectations due to your condition? An important topic of conversation every family should have is how much or how little medical treatment they would like to have if they are in a life-threatening situation and unable to communicate their preferences.
Due to the nature of severe COVID-19 illness, many of the sickest patients are unable to communicate, so this conversation is very relevant, regardless of your stage in life. While it may not be pleasant to discuss, it is beneficial in reducing the emotional burden on family members and ensuring that your wishes are met. Advanced directives can help you plan for end-of-life care and make your desires known in order to make decisions easier on your loved ones.
Basic facts
Advance directives are legal documents that express your expectations for end-of-life medical care. They only come into effect when you’re physically unable to communicate due to a medical condition. It will not affect your care when you are able to make your own decisions. Advance directives include:
- Living Will: A legal document that communicates your expectations for medical care if you are seriously injured, have a terminal illness or late-stage dementia, are in a coma, or are near the end of your life. A living will instructs your caregivers, loved ones and medical providers how to proceed with medical care if you are unable to make decisions due to your condition. This document must be written according to the laws of your state.
- Medical Power of Attorney: A medical power of attorney is a person you choose to make medical decisions on your behalf. This person serves an important role and should be someone you trust and can rely on.
Importance of advance directives
Keeps you in charge: An advance directive gives you the ability to express your desire for medical care when you’re unable to communicate so you receive the same level of care that you would choose if you were able to communicate your own decisions.
Enables your doctors to provide the level of care you desire: Advance directives aren’t just about denying care in a serious situation, they can also explain that you would like all possible measures taken to save your life, or something in between. Bottom line: Your expectations are known and your providers have the ability to act accordingly, even if you’re unable to communicate it.
Reduces the burden on your family: Advance directives can alleviate the emotional burden and feelings of guilt and pressure on your loved ones, and removes some of the responsibility from family members.
Completing your advance directive
Every state has their own form, process and requirements to complete for advance directives. It is important to note that if you live in multiple states, you will want to complete multiple state forms, as they may differ state to state, to avoid issues should an emergency arise. Access forms by state here.
Reviewing your advance directive
If you already have completed an advance directive, or plan to, it is important to periodically review your forms in case you want to make any changes. The American Bar Association Commission on Law and Aging recommends reviewing your advance directive whenever you experience any of the 5 D’s.
- Decade: Each time you start a new decade of your life—30, 40, 50, 60 and so on.
- Death of a loved one
- Divorce (especially important if your former spouse was your medical power of attorney)
- Diagnosis: If you are diagnosed with a serious medical condition.
- Decline: If your physical and mental health and overall condition begins to deteriorate.
Additional life changes that may warrant reexamining your advance directive include:
- Birth of a child
- Marriage
- Improvement in a condition or prognosis
- Change in belief and values
If you change your advance directive…
Follow your state protocol for destroying old versions and updating new ones.
Immediately notify your medical power of attorney and provide the updated version.
Provide the updated version to your healthcare providers and advise them to destroy the previous versions.
While we hope advance directives are never needed, it is highly recommended that every adult age 18+ completes and regularly reviews theirs as a precaution.
