From the Guidelines
An advance directive is a legal document that outlines your wishes for medical care if you become unable to make decisions for yourself, ensuring your healthcare preferences are known and respected even when you cannot communicate them yourself. It typically includes two main components: a living will that specifies what medical treatments you would or would not want in certain situations (such as life support, resuscitation, or artificial nutrition), and a healthcare power of attorney (also called a healthcare proxy) that names someone you trust to make medical decisions on your behalf 1.
Creating an advance directive is important because it ensures your healthcare preferences are known and respected even when you cannot communicate them yourself. To create one, you should consider your values and preferences regarding end-of-life care, discuss them with loved ones, and work with a healthcare provider and possibly an attorney to complete the appropriate forms for your state. Once completed, distribute copies to your healthcare proxy, family members, and healthcare providers, and review it periodically to ensure it still reflects your wishes.
Some key points to consider when creating an advance directive include:
- The importance of communicating effectively with your healthcare provider and loved ones about your wishes and preferences 1
- The need to review and update your advance directive periodically, especially after major life events or changes in your health status 1
- The role of advance directives in reducing family stress and preventing unwanted medical interventions during medical crises 1
- The importance of respecting patient autonomy and self-determination in end-of-life care decisions 1
By creating an advance directive, you can ensure that your healthcare preferences are respected and that you receive the care you want, even if you are unable to communicate your wishes yourself. It is essential to prioritize creating an advance directive to ensure your quality of life and prevent unwanted medical interventions.
From the Research
Definition of Advanced Directive
- An advanced directive is a document that outlines a person's wishes for their medical treatment in the event that they become unable to make decisions for themselves 2.
- It can include instructions for life-sustaining treatments such as cardiopulmonary resuscitation (CPR), mechanical ventilation, and artificial nutrition and hydration 2, 3.
- Advanced directives can be used to ensure that a person's autonomy and preferences are respected, even if they are no longer able to communicate their wishes 4.
Components of Advanced Directives
- Advanced directives can include a range of instructions, such as:
- Do-not-resuscitate (DNR) orders, which indicate that a person does not want to receive CPR if their heart stops or if they stop breathing 2, 4.
- Instructions for mechanical ventilation, which can include decisions about whether to start or continue ventilation, and under what circumstances 3, 5.
- Decisions about artificial nutrition and hydration, which can include instructions about whether to start or continue these interventions 2, 3.
- Advanced directives can also include information about a person's values and preferences, such as their views on quality of life, pain management, and end-of-life care 3, 4.
Importance of Advanced Directives
- Advanced directives are important because they can help ensure that a person's wishes are respected, even if they are no longer able to communicate their preferences 2, 4.
- They can also help reduce conflict and uncertainty among family members and healthcare providers, by providing clear guidance on a person's wishes for their medical treatment 4.
- Advanced directives can be particularly important for people who are at risk of losing decision-making capacity, such as those with dementia or other cognitive impairments 3.