Dear Marci,
I’m 68 years old, I have Medicare, and I’m very healthy. My daughter recently suggested that I should consider putting together an advance directive and some other documents about my health care preferences in the future. What is this, and why would I need one if I’m healthy and able to communicate about my preferences?
-Marisol (Tampa, FL)
Dear Marisol,
Advance directives and living wills are legal documents that give instructions to your family members, health care providers, and others about the kind of care you would want to receive if you can no longer communicate your wishes because you are incapacitated by a temporary or permanent injury or illness. Other kinds of documents, like health care proxies and powers of attorney, appoint a trusted individual to make certain kinds of decisions on your behalf in certain situations.
Many people assume that their family members would automatically be able to make decisions about medical treatments if they were to become incapacitated. Each state has different rules regarding who becomes the default decision-maker if you do not have a health care proxy or some other means of expressing your treatment wishes. If you become unable to make medical decisions because you are incapacitated by a temporary or permanent injury or illness, anyone from your next of kin to hospital administrators could be making treatment decisions on your behalf.
If you are able, it is important you put your health care wishes in writing. If you do not:
- Your family may have to go through a costly and time-consuming court process to get the legal right to make medical decisions for you (called guardianship or conservatorship).
- Your family members may disagree on who should make medical decisions on your behalf, which could lead to legal disputes.
- Someone unfamiliar with your preferences may be placed in charge of your treatment decisions.
It is therefore important to have a plan ahead of time to avoid disagreements around treatment issues if you are incapacitated. Advance directives, living wills, health care proxies, and powers of attorney can help ensure that decisions made on your behalf meet your needs and preferences:
- Health care proxy: A document that names someone you trust as your proxy, or agent, to express your wishes and make health care decisions for you if you are unable to speak for yourself.
- Living will: A written record of the type of medical care you would want in specific circumstances.
- Advance directive: Often refers to a combination of the living will and health care proxy documents.
- Power of attorney: A document—typically prepared by a lawyer—that names someone you trust as your agent to make property, financial, and other legal decisions on your behalf.
You may choose to appoint the same person to be in charge of your medical and financial decisions by naming them your health care proxy and granting them power of attorney. However, doing so usually requires two separate documents.
If you have an advance directive, your doctors should make note of it in your medical record. Be sure to give these documents to the hospital each time you are admitted.
-Marci