What happens when you lose your capacity to make decisions about your medical care?
The news these days is full of stories about people on life support and their family members fighting over whether brain dead means something different than dead.
What if you were the one on life support? What would you choose?
Ideally, you would have already chosen, and your wishes would be clearly spelled out in your Advance Healthcare Directives. Unfortunately, only about 30% of Americans have made their wishes known.
Advance directives are not just needed by older adults; young people on life support are making the news. Advance Directives are important for all adults.
What are Advance Healthcare Directives?
Advance Healthcare Directives are a key component of your estate plan. Your Last Will and Testament specifies how you want your estate to be distributed upon your death. Your Power of Attorney appoints someone you trust to take charge of your finances if you become incapacitated. In your Advance Healthcare Directives you will:
- Appoint a healthcare representative, sometimes called healthcare agent or durable power of attorney for healthcare. As with the durable power of attorney for financial decisions, you should appoint someone you trust who will act on your behalf if you aren’t capable.
- Define the types of medical interventions and life support measures you want – or do not want – at the end of your life. This is called your Living Will.
What is life support?
Some of the commonly used life support measures include:
- Artificial nutrition and hydration (tube feeding)
- Cardiopulmonary resuscitation
- Mechanical ventilation
- Kidney dialysis
How do you decide which, if any, life support measures to accept? According to the Cleveland Clinic:
“A treatment may be beneficial if it relieves suffering, restores functioning, or enhances the quality of life. The same treatment can be considered burdensome if it causes pain, prolongs the dying process without offering benefit, or adds to the perception of a diminished quality of life.”
What you decide is up to you and you alone. You may want every technological innovation available regardless of your medical condition, or you may choose to have a good quality of life without excessive life prolonging interventions.
The only way your family members or physicians will know your wishes is if you tell them, and to tell them in a written, legally enforceable document. They may not agree, but they cannot dispute what you have decided if it is unambiguously stated in your Living Will.
Do advance directives vary by state?
Each state has different legal requirements for advance healthcare directives. In Connecticut, four types of advanced directives are defined but not required by law:
- Appointment of a healthcare representative (similar to a health care power of attorney)
- Living Will (concerning end of life)
- Document of anatomical gifts
- Designation of Conservator of Person for future incapacity (appointed by Probate Court)
What if I want to change my advance directives?
Your Advance Directives are not written in stone. You should re-visit your healthcare wishes every few years or whenever any of the “5 D’s” occurs:
- Decade – when you start each new decade of your life.
- Death – whenever you experience the death of a loved one.
- Divorce – when you experience a divorce or other major family change.
- Diagnosis – when you are diagnosed with a serious health condition.
- Decline – when you experience a significant decline or deterioration of an existing health condition, especially when it diminishes your ability to live independently.
( Source: American Bar Association)
Who should get a copy of my advance directives?
According to the State of Connecticut, you should tell the following people that you have completed an advance directive and give them copies of the directives you have made:
- Your Physician
- The person(s) you have named as your health care representative
- Anyone who will make the existence of your advance directives known if you cannot do so yourself such as family members, close friends, your attorney or your clergy
There is another new Connecticut form you should know about – it is essentially a medical order form that contains your treatment instructions. Unlike the advance directive, this form goes into effect as soon as it is signed, regardless of your capacity to make decisions. Click here to learn more.
Life is full of surprises – don’t leave your end of life plans to chance. Take charge now and, working with a Connecticut estate planning attorney, clearly spell out your wishes in your Advance Healthcare Directives. If you don’t, someone else will make the choices. And that’s a pretty scary thought.
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