Advance Directives: What Should You Know?

Advance Directives: What Should You Know?

National Healthcare Decisions Day (NHDD) was a week-long event this year (April 16-22), and aimed to help people across the U.S. understand the value of advance health care planning. The theme for 2017 was “It always seems too early, until it’s too late.” This sentiment captures the essence of why having an advance directive is so important. Putting off planning for your end-of-life wishes not only deprives you of making decisions about your own life, it also can put your health care providers and your family in crisis.

What is an advance directive?
Advance directives are legal documents telling your family and your health care providers what type and level of treatment you want to receive in the event that a terminal illness or injury renders you unable to communicate for yourself, and who has the authority to make medical decisions for you if you’re in such a condition. Advance directives generally include:

1) Health care instructions (sometimes known as a “living will”)
This describes specifically whether or not you want to receive life support and/or artificial nutrition and hydration in each of the following conditions:
• Close to death: Terminal illness in which death is imminent with or without treatment, and where life support will only postpone the moment of death.
• Permanently unconscious: Completely lacking an awareness of self and external environment, with no reasonable possibility of a return to a conscious state.
• Advanced progressive illness: A progressive illness that will be fatal and is unlikely to improve.
• Extraordinary suffering: Illness or condition in which life support will not improve the person’s medical condition and would cause the person permanent and severe pain.

2) Appointment of a health care representative (or proxy)
You can name someone 18 years or older as your health care representative – someone who will be allowed to make medical decisions if you are not able to – as long as the chosen individual and one other witness sign the document. This representative would make decisions for you such as whether to withhold or remove life support, food, or hydration.

How do I set up an advance directive?
You can fill out an advance directive form without needing a lawyer. Forms are available through multiple sources, but make sure you are filling out one that is approved in your state. You can find Oregon-specific information and a link to the form here. You can also pick up a copy at HDH Family Care or HDH’s admitting desk. Once the form is signed in the presence of two witnesses, be sure you make it known to your primary care provider and family members. •

Advance Directive FAQ

Do I have to have an advance directive?
No. No health care provider or insurer can require you to have an advance directive, or charge a different fee or rate if you do or do not have one.

When does my advance directive take effect?
An advance directive only takes effect when you can no longer make your own health care decisions due to being in a terminal condition or permanently unconscious state.

How long does an advance directive last? Can I change my mind?
Unless you specifically limit the duration, an advance directive will not expire. However, you may change or cancel it at any time — simply destroy the document and notify anyone that has received a copy of it.

Do I need a lawyer? Does the document need to be notarized?
You may choose to consult with a lawyer, but there is no legal requirement in Oregon to do so. Simply fill out the provided Oregon form, and sign it in the presence of two qualified adult witnesses. There is no legal requirement in Oregon to have the document notarized, however, if you want to try to ensure it will be valid in other states, it could be a good idea.

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