An Advance Directive Records Wishes and Protects Loved Ones

Do you want to be kept alive by a breathing machine? Do you want pain medicine to keep you comfortable at end-of-life? Who do you want to make care decisions for you? These are challenging questions that people often feel strongly about and may disagree on. An advance directive tells others what you want when you can’t communicate your wishes.

“Advance directives are legal documents that ensure your wishes are being followed and not someone else’s,” said Director of Education and Employee Health at Memorial Hospital of Sweetwater County, Patty O’Lexey. “They also keep the burden of making these decisions from being put on your family.”

Advance Directives are for Everyone

You don’t need to have a serious illness or be an older adult to have an advance directive — all adults should have one.

Some people hesitate to make an advance directive because they are unsure what they will want at end-of-life or worry their wishes might change. However, for most people, taking the time to think about your options and talk with family members and friends about your wishes can help clarify your wishes.

While we all hope for a long, healthy life, none of us knows what’s around the corner. “Creating an advance directive is a proactive way to make decisions,” O’Lexey said. “If something happens, advance directives make decisions clear for your loved ones.”

Common Types of Advance Directives

A durable power of attorney for health care and a living will are the most common types of advance directives. Including information about organ and tissue donation with your advance directives is also common.

Durable Power of Attorney for Health Care

A durable power of attorney for health care, also called a medical power of attorney, is a document that names someone to make healthcare decisions for you if you can’t make them for yourself. Legally this person is called your healthcare agent or proxy.

Your healthcare agent can make decisions about what types of treatments you receive. They can also make decisions about other aspects of care, such as if you should be placed in a nursing home or other care facility.

It’s essential that you choose a healthcare agent you know well and are confident will respect and follow your wishes.

Living Will

A living will is a legal document that describes what type of care you want and do not want at end-of-life, including:

• Comfort care measures to control pain or other uncomfortable symptoms
• Intravenous (IV) fluids
• Life-sustaining treatments, such as a ventilator to keep you breathing or a dialysis machine to keep your kidneys working
• Tube feeding

The living will only takes effect if you cannot communicate your wishes and are either terminally ill or permanently unconscious.

State Laws About Advance Directives

Every state has slightly different laws regarding advance directives. In Wyoming, the state legislature created a recommended advance directive form that combines a durable power of attorney for health care, living will, and organ donation form into one.

Advance directives from one state are often honored in others. However, if you spend a significant part of your time in another state, it’s a good idea to double-check that state’s laws. If the laws differ, consider creating a second advance directive specific to that state.

End-of-Life Orders

Do not resuscitate, usually known as a DNR, orders and physician orders for life-sustaining treatment, also called portable medical orders, are documents that give healthcare providers more information about your wishes at end-of-life. However, these documents are not types of advance directives. Instead, they are orders created in partnership with and signed by a medical provider. Typically, they are only created if someone has a serious illness.

What to Do Next

If you don’t have an advance directive, your next step is to create one. Once you have one, follow these steps:

1. Tell your close friends and family members that you have an advance directive.
2. Give copies to your:
   • Healthcare agent
   • Alternate healthcare agent
   • Primary care providers and healthcare facilities
   • Trusted people who you would like to have a copy
3. Put your advance directive in an easy-to-find place and tell others where it is — consider putting a copy in an envelope and putting it on your fridge.

If you have a significant life change, like a marriage or divorce, or change your mind about care options later, that’s OK. While advance directives are legally binding documents, they are not set in stone. As long as you can make your own healthcare decisions, you can create new advance directives.

“Our minds can change as our health changes,” O’Lexey said. “Update your advance directive when things change and ensure you keep your health care agent up to date to make sure they understand your wishes.”

If you need assistance creating your advance directive, call 307-352-8518 to talk with your Memorial Hospital of Sweetwater County case manager.