Life Care Planning: Advanced Directives
Advanced Directives are laws that allow you to make future health care treatment decisions in the event you become incapacitated at some point in the future and are unable to make these decisions your family and doctors will know what medical care you do want or do not want.
Communicate your directives by completing a Durable Healthcare Power of Attorney form which allows you to specify your wishes regarding specific life sustaining treatments and select a healthcare representative to make these future health care decisions in the event you become too ill to make your own decisions.
Life-sustaining treatments are specific medical procedures that support the body to keep a person alive when the body is not able to function on its own. You might want to accept life-sustaining treatments if they will help to restore normal functions and improve your condition. However, if you are faced with a serious life-limiting condition, you may not want to prolong your life with life-sustaining treatment.
These documents are only valid when your doctor declares that you are unable to make your own medical decisions. It is only at this time that your appointed medical power of attorney can step in and make healthcare decisions for you. You can always make your own medical decisions as long as your doctor states that you are of sound mind and have the mental capacity to make those decisions.
When selecting a healthcare representative, choose someone who knows you well or is a trusted friend or relative who clearly understands your healthcare wishes. Be sure that you have voiced your choices not only to this person but also to your doctor.
The following are common end-of-life medical options to consider:
Cardiopulmonary resuscitation (CPR) is a group of procedures used when your heart stops (cardiac arrest) or breathing stops (respiratory arrest). For cardiac arrest the
treatment may include chest compressions, electrical stimulation or use of medication to support or restore the heart’s ability to function.
A Do Not Resuscitate order (DNR) is a written physician’s order that prevents the healthcare team from initiating CPR according to your wishes, your family’s wishes or your surrogate or agent’s wishes.
A Do Not Intubate (DNI) order is another written physician’s order. Intubation is the placement of a tube into the nose or mouth in order to have it enter your windpipe (trachea) to help you breathe when you cannot breathe on your own adequately.
Intubation might help prevent a heart attack or respiratory arrest. The DNR order must be signed by a doctor to be legally valid.
Refusal of intubation does not mean refusal of other techniques of resuscitation. If you do not want mechanical ventilation (breathing) you must discuss intubation because it may be included as part of a DNR order. Even if you have completed a DNR order that does not mean that you have refused to be intubated. If you want life mechanically sustained you must discuss your decision about intubation with your doctor.
Artificial Nutrition and Hydration are treatments that allow a person to receive nutrition (food by feeding tube) and hydration (fluids – oral or IV) when the patient is no longer able to take them by mouth. When someone with a serious or life-limiting illness is no longer able to eat or drink, it usually means that the body is beginning to stop functioning as a result of the illness.
Completing your Durable Healthcare Power of Attorney
- You can do this without a lawyer.
- You must use forms specifically created for your state so that they are legal.
- The law requires that you sign and date your Arizona Health Care Directive in the presence of at least one (1) adult witness. You can do this in either of two ways:
- Sign and date your document in the presence of at least one witness, who must also sign the document and affirm that he/she was present when you dated and signed the document, AND that you appeared to be of sound mind and free from duress at the time you signed the document, and (c) he/she does not fall into any of the categories of people who cannot be a witness. Your witness cannot be:
- related to you by blood, marriage, or adoption
- entitled to any part of your estate, by will or operation of law, at the time the document is signed
- appointed as your agent or
- involved with the provision of your health care at the time the document is signed.
- Have your signature witnessed by a notary public who is neither your agent nor a person involved with the provision of your health care at the time the document is signed. The notary must also affirm that he/she was present when you dated and signed the document, AND you appeared to be of sound mind and free from duress at the time you signed the document. The notary cannot be appointed as your agent, or involved with the provision of your health care at the time the document is signed.