Health Notes January 2015
● By Aimee Cormier
by Ellen S. Mullen M.D.
Death is not anyone’s favorite subject but since we will all have to deal with it at one time or another it is something you should think about and decide how much input you would like to have on your end of life decisions. Advanced directives are one way of telling your family and doctor what kind of care you would like to have if you become unable to make medical decisions. Advanced directives help to guide your doctor in deciding what treatment you may want or if there are treatments you do not ever want. Each state has different laws regarding
There are many different types of advanced directives. A living will is one type that only comes into effect when you are terminally ill. A terminal illness usually means having less than 6 months to live. It allows you to describe the kind of treatment you want in certain situations. A living will does not let you select someone to make decisions for you.
A durable power of attorney (DPA) for health care is a type of advanced directive which states who you have chosen to make health care decisions for you. It only becomes active if you are
unconscious or unable to make medical decisions.
A do not resuscitate (DNR) order is another type of advance directive. A DNR order tells the hospital staff that if your heart stops beating or you stop breathing you do not want any assistance such as chest compression, respiratory ventilations or to have your heart shocked. If you do not have a DNR in your chart in a hospital the hospital staff will automatically try to resuscitate you.
If you are interested in writing an advanced directive you can speak to your doctor, ask at a local hospital or discuss it with a lawyer. First you should decide what your wishes are. You will want to write them down and then discuss this with your doctor. You may want to have the document notarized and send copies to family members and to your doctor. If you are seriously ill you may want to post a copy on your refrigerator since this is the first place a paramedic looks to see if you have an advanced directive.
Advanced directives may be changed at any time as long as you are of sound mind. You should write your changes and have them notarized. However verbal wishes, made in person, will usually be followed in the place of written ones if they are communicated clearly. Be sure you communicate these wishes to your doctor and to your family members so there are no misunderstandings.