A time may come when you or a loved one is seriously injured or becomes gravely ill. Although we may prefer not to think about such a situation, we need to be prepared for the difficult decisions that may need to be made about the intensity of medical care or whether life support should be continued or withdrawn. The stress of the situation coupled with shock and grief make it even harder to make such tough decisions. By learning about the various options available, you can ease the pain of such situations and ensure your wishes are carried out.
”Advance Directive” is a term that covers several documents that lay out what kind of medical care you want. This can include specifying what treatments you do or do not want in certain cases or it can be naming a person to make health decisions for you if you are unable to for yourself.
Why have an Advance Directive?
- To protect your right to make choices about medical care that affect your life.
- To make your doctor and other caregivers aware of the kind of medical care you want, or do not want, in the event that you are too sick or injured to speak for yourself.
- To help relieve your family and loved ones of the stress of making difficult decisions for you.
Preparing an Advance Directive
The best way to prepare an Advance Directive is in the comfort of your home, when you have time to think about and carefully consider your choices. It is important that you discuss your wishes with your family, friends and loved ones. A lawyer may be helpful in assisting you to execute an Advance Directive or you may link to the forms from this page.
Types of Advance Directives
Living Will: A Living Will, also called a Directive to Physicians, takes effect while you are still living and clearly outlines your wishes regarding health care during a medical emergency if you are unable to speak for yourself. It is important that you give a copy of your Living Will to your physician to put in your medical file so that your instructions can be understood and followed. It is your responsibility to give a copy to all facilities where you may receive health care. Also, let a family member or close friend know where to find a copy if it is needed.
A Living Will goes into effect from the date your doctor receives a copy, determines you are unable to make your own healthcare decisions and determines you are terminally ill or have an irreversible condition. The Living Will has limited use and only applies if you have a terminal medical condition such that death is expected soon. It can be changed or revoked at any time.
Medical Power of Attorney for Health Care: This document allows you to appoint another person to make decisions about your medical care when you are unable to for yourself due to mental or physical reasons. The person must be at least 18 years of age and should be someone whom you know and trust. Make certain that whomever you grant Medical Power of Attorney for Health Care fully understands your desires and that they are willing to follow your wishes. You may include specific directions for your care in a Medical Power of Attorney for Health Care just as you would in a living will.
Your representative has the power to make a broad range of health care decisions for you. They may consent, refuse to consent or withdraw consent to medical treatment, which can include life-support treatment. However, your representative may not consent to voluntary inpatient mental health services, convulsive treatment, psychosurgery or abortion.
Even after you have signed the Medical Power of Attorney for Health Care, you still have the right to make health care decisions for yourself as long as you are able to do so. Treatment cannot be given or stopped if you indicate an objection. A Medical Power of Attorney for Health Care can be changed or revoked at any time.
Out-of-Hospital Do-Not-Resuscitate Order: There may come a time when, due to a terminal condition or the possible consequences, you decide you want to die a natural death without being revived. An Out-of-Hospital Do-Not-Resuscitate (DNR) order is for the purpose of instructing Emergency Medical Personnel and other health care professionals to forgo resuscitation attempts and to permit the patient to have a natural death with peace and dignity. This order does NOT affect the provision of other emergency care including comfort care. It simply states your wish to not have cardio-pulmonary resuscitation (CPR), which generally consists of chest compressions, artificial ventilation techniques, medication and electrical shocks to the heart.
An Out-of-Hospital DNR order is valid in the Emergency Department, ambulance, long-term care, and in the home. For a DNR while in the hospital, please inform your healthcare personnel upon admission.
For More Information
If you need assistance or want more information from someone at Coryell Memorial Healthcare System, please contact the Social Services Dept. at (254) 248-6330.
You can obtain printable forms and other Advance Directives at the Texas Department of Aging and Disability website here.