Advance Directives is the term given to legal documents that detail a person’s preferences regarding health care treatments and decisions, should he or she be unable to make those decisions due to such conditions as uconsciousness or loss of mental capacity. Advance directives typically include at least two documents: the living will and the durable power of attorney for healthcare. Some individuals prepare additional advance directives, such as organ donation preferences and do not resuscitate orders (DNR), sometimes used in situations of terminal illness, very advanced age or intractable pain.
As a family caregiver, it’s important that you have a clear understanding of your parent’s wishes regarding health care. This can greatly reduce stress and the potential for family discord when faced with difficult decisions.
Types of advance directives:
Living Will - a legal document that expresses your parent’s wishes for medical treatment in specific circumstances, including whether they want to receive life-sustaining treatments in the event of a terminal illness or accident in which they are injured or otherwise become incapacitated. (A living will deals only with medical matters.)
Durable Power Of Attorney For Healthcare - a legal document by which someone grants authority to another person, known as an agent, to make decisions regarding medical care in the event the person is unable to do so, due to unconsciousness or lack of mental capacity. This agent is also called attorney-in-fact for health care, health proxy or health surrogate. In addition to naming a primary health care proxy, a secondary and tertiary health care agent should be identified in the event the primary agent is not available.
Organ Donation - this type of advance directive specifies if one would like to be an organ and/or tissue donor. Laws vary by state, so be sure to check what applies where you live. In some states one must be registered as an organ donor in addition to indicating this preference in an advance directive.
Do Not Resuscitate Order - a request not to have cardiopulmonary resuscitation (CPR) if you stop breathing or your heart stops. If a DNR is not in place, then medical staff will attempt to resuscitate. If your parent requests a DNR, it is important to have this at the bedside at home at all times. If your parent is hospitalized or in a nursing home, be sure that the correct documents are in your parent’s chart and that you have discussed with the medical and nursing staff so that your parent’s wishes will be followed.