“Advance care planning is a process for setting goals and plans with respect to medical care and treatment,” explains Charles Sabatino, director of the American Bar Association’s Commission on Law and Aging. Documents appointing a representative and setting forth instructions about your health care wishes when you are not able to make them yourself are called advance directives.
Advance directive documents include:
1. Living will – allows you to determine if you want your life artificially prolonged by tubes and machines;
2. Durable Healthcare Power of Attorney – allows you to appoint someone to make medical decisions for you if you are unable to make them for yourself;
3. Physician Orders for Scope of Treatment – allows individuals with a chronic or terminal illness or chronic frailty to determine the scope and extent of treatment they wish to received related to the illness from which they suffer.
Sabatino wants to debunk many of the myths and misunderstandings people have about advance directives:
Myth: Each state has its own form and you have to use that form for your document to be valid. Truth: Most states do not require a particular form, but there may be witnessing requirements for documents.
Myth: Advance directives are legally binding and doctors have to follow them.
Truth: Doctors can refuse to comply with your wishes if they consider them medically inappropriate, but they have an obligation to help transfer you to another health care provider who will comply.
Myth: An advance directive means “do not treat”.
Truth: The document can express both what you want and what you don’t want. You should always be given “palliative care” to keep you pain-free and comfortable, addressing medical, emotional, social, and spiritual needs.
Myth: If I name a health care proxy or representative, I will be giving up the right to make my own decisions.
Truth: You always have the right to override the decision or revoke the directive.
Myth: If my advance directive says “do not resuscitate”, emergency technicians will not resuscitate me if 911 is called.
Truth: EMS must attempt to resuscitate you and transport you to a hospital except in the case of people with terminal illnesses who have in place out-of-hospital DNR orders.
Myth: Advance directives are only for older people.
Truth: Every adult should have an advance directive.
Directives need to be done in advance! We encourage all individuals to have health care documents in place, and even more importantly, to discuss their specific wishes with their family.