Making Decisions for Your Advance Directive

Thinking about your health care wishes and making an advance directive can be done by anyone at any age. Throughhonest talks with your loved ones, you can explain what’s important to you and what kind of treatments you do and do not want. These talks can save your loved ones from guilt, uncertainty, or conflict if decisions about your health need to be made and you are unable to make them. Your loved ones can help make sure that your wishes are followed, but first they must know and understand what you want.

Some important steps and things to consider might include:

• Learn more about different advance directives such as a living will, durable power of attorney for health care, and/or other advance health care instructions. Understand the meaning of each and the differences.
• Discuss your decisions and wishes with your spouse or partner, family members, close friends, your health care provider, and/or your attorney. Telling those close to you about your end-of-life decisions will help ensure that your wishes are carried out.
• Decide who you want as your health care proxy or agent (decision-maker in case you are unable to make your own decisions). This is an important decision to make. Carefully choose someone you believe will be able to carry out your wishes even if it may mean ending life-sustaining treatments. Talk with the person to be sure they’re OK with doing this for you and that they understand your wishes. You may also choose to name a back-up person in case your first choice becomes unable or unwilling to act on your behalf.
• If you have a health care proxy or agent (durable power of attorney for health care), give them a copy of your advance directive to keep in a safe place where it can be found quickly if needed. You may also give copies to loved ones who are likely to be nearby. Be sure your loved ones know who your health care proxy or agent is.
• If you want a living will, or if you’re writing detailed instructions, be specific about such things as CPR (cardiopulmonary resuscitation), breathing machines (ventilators or respirators), medicines to make your heart work, kidney dialysis, artificial feeding (tube or intravenous), and certain surgical procedures.
• Remember, before your health care team uses your living will to guide medical decisions or your health care proxy can make medical decisions on your behalf, two physicians must confirm that you are unable to make your own medical decisions.
• If you need help writing an advance directive, ask your health care team if they might be able to help. You might also consider contacting an attorney or a mediator. But, most people don't need an attorney to write an advance directive.
• Do not lock your advance directive in a safe-deposit box, home safe, or filing cabinet that only you can open. Let your loved ones know where your original copies are.
• Be sure your health care team has your advance directive in their records. You may also keep copies of your advance directive in easy-to-find places so that someone else can find it if you are in the hospital and need it. You might also give a copy to your attorney and be sure your family knows exactly who has it.
• You can also store your advance directive on the U.S. Living Will Registry (now known as the Advance Care Plan Registry) and access it at any time.
• Every once in a while, remind your health care proxy about your advance directive and their important responsibility. If your wishes change, be sure to talk this over with your proxy, your loved ones, and your health care team and update your advance directive.