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Living Wills and Advance Directives for Medical Decisions

Living Wills and Advance Directives for Medical Decisions

Plan ahead and get your Medical care you want at the end of your life.

Mayo Clinic Staff

Living wills and other advance directives are written, legal instructions about your medical care preferences if you are unable to make your own decisions. If you are terminally ill, seriously injured, in a coma, have advanced dementia, or are near the end of your life, advance directives guide your doctor and caregiver choices.

Advance directives are not just for seniors. Unexpected end-of-life situations can occur at any age, so all adults must have these documents ready.

By planning ahead, you can get medical care in times of crisis or grief, avoiding unnecessary suffering and reducing the decision-making burden for caregivers. You also help reduce confusion or disagreement about the choices you want people to make on your behalf.

Power of Attorney

A medical or health care power of attorney is a An advance directive in which you can appoint someone to make decisions for you if you cannot. In some states, this directive may also be called a durable power of attorney for health care or a health care agent.

Depending on where you live, the person you choose to make decisions on your behalf may be called one of the following:

  • )Healthcare Agency
  • Healthcare Agent Healthcare Agent Healthcare Representative
  • Healthcare Agent

Patient Advocate

Selected It’s important to have one person as your healthcare surrogate. Even if you have other legal documents about your care, not all situations are predictable, and some situations require someone to make judgments about your likely willingness to care. You should choose someone who matches the following criteria:

      matches where you are State Requirements for Healthcare Agents NOT PART OF YOUR DOCTOR OR YOUR HEALTH CARE The team is willing and able to discuss medical and end-of-life issues with you

      Can be trusted to make decisions that match your wishes and values ​​

    • If there is disagreement about your care, you can be trusted to be your advocate
    • The person you designate may be your spouse, other family member, friend or member of a faith group. You can also choose one or more replacements if the person you choose is unable to perform the duties.

      Living Will

      Living Will is a written Legal documents detailing the medical care you do and do not want to be used for life-sustaining, as well as your preference decisions for other medical care, such as pain management or organ donation.

      When determining your wishes, please consider your values. Consider how important independence and self-sufficiency are to you, and identify situations that might make your life not worth living. In any case, would you like to prolong your life with treatment? all cases? Do you only need treatment if it can be cured?

      You should state some possible end-of-life care decisions in your Living Will. Consult your doctor if you have any questions about any of the following medical decisions:

        CPR Restart When the heart stops beating. Determine if and when you want to be resuscitated with CPR or with a device that delivers shocks to stimulate the heart. Mechanical Ventilation Takes over your breathing if you can’t breathe on your own. Consider if, when and how often you will need a mechanical ventilator.

        Tube feeding

        provides nutrients and fluids to the body either intravenously or through a catheter tube in stomach. Decide if, when, and how often to feed in this way.


        removes waste products from your blood and controls fluid levels when your kidneys are not functioning longer function. Find out if, when, and how long you want to have this treatment. Antibiotics Or antiviral drugs can be used to treat many infections. If you are nearing the end of your life, do you want to aggressively treat the infection or let the infection run its course? Comfortable Nursing (palliative care)

        includes any number of interventions that can be used to keep you comfortable and manage pain while adhering to your other treatments desire. This may include being allowed to die at home, taking painkillers, feeding ice cubes to relieve dry mouth, and avoiding invasive tests or treatments. Organ and Tissue Donation transplants can be specified in your Living Will. If your organ is removed for donation, you will temporarily receive life-sustaining treatment until the surgery is complete. To help your health care agent avoid any confusion, you may need to state in your living will that you understand the need for this temporary intervention.

        Donating your body

        can also be designated for scientific research. Contact your local medical school, university, or endowment program to learn how to sign up for a planned research endowment.

        Don’t resuscitate, Do Not Intubate Orders

        You do not need an Advance Directive or Living Will to get a Do Not Resuscitate (DNR) and Do Not Intubate (DNI) Order. To create a DNR or DNI command, tell you doctor about your preferences. He or she will write the doctor’s order and place it in your medical record.

        Even if you already have a living will that includes your preferences for resuscitation and intubation, it establishes the DNR or DNI orders are still a good idea every time you check into a new hospital or healthcare facility.

        Preparation of Advance Directives

        Advance Directives need to be in writing . Each state has different forms and requirements for creating legal documents. Depending on where you live, the form may need to be signed by a witness or notarized. You can ask a lawyer to help you with the process, but it’s usually not necessary.

        Links to state-specific forms such as the American Bar Association, AARP, and the National Hospice and Palliative Care Organization can be found on the websites of individual organizations.

        Review your advance directive with your doctor and your healthcare agent to make sure you have completed the form correctly. After completing the file, you need to do the following:

        • Copy the original Keep in a safe and easily accessible place.
            Give a copy to your doctor.

            Give your healthcare agent and any alternate agents a copy. Record who has your advance directive. Discuss your advance directive and your medical care with family members and other important people in your life health wishes. By having these conversations now, you can help ensure that your wishes are clearly understood by your family. Having a clear understanding of your preferences can help your family avoid conflict and guilt.

            Carry a wallet-sized card indicating that you have advance directives, identification your healthcare agent and state where a copy of your instructions can be found. Take a copy with you when you travel.

            Review and change advance directives

            You can change your instructions at any time. If changes are to be made, new forms must be created, new copies distributed, and all old copies destroyed. The specific requirements for changing directives may vary from state to state.

            You should discuss the change with your PCP and make sure the new order replaces the old order in your medical file. The new order must also be added to the hospital or nursing home medical record. Also, talk to your healthcare agent, family, and friends about the changes you’ve made.

            Consider reviewing your order and creating a new order if:

              New diagnosis.

            Diagnosing an advanced disease or a disease that significantly changes your life may cause you to change your desire to live. Talk to your doctor about possible treatment and care decisions that may be made during the expected course of the disease. Marriage change of situation.

            When you are married, divorced, separated or widowed, you may need to choose a new health care surrogate.

            approximately every 10 years.

            Your thoughts on ending-life care may change over time. Review your directives from time to time to ensure they reflect your current values ​​and aspirations.

            Maintain Physician’s Order for Life-Sustaining Treatment (POLST)

            In some states, advance health care plans include a document called a Physician’s Order for Life-Sustaining Treatment (POLST) . This document may also be called a Provider’s Order for Life Support Treatment (POLST) or a Medical Order for Life Support Treatment (MOLST).

            A POLST for people who have been diagnosed with a serious medical condition . This form does not replace your other instructions. Instead, it serves as a doctor-ordered instruction — not the same as a prescription — to ensure that in an emergency, you get the treatment you like. Your doctor will fill out the form based on your advance directives, your discussions with your doctor about your likely course of disease and your treatment preferences.

            A POLST is with you. If you are in a hospital or nursing home, this document will be posted by your bedside. If you live at home or in a hospice, this document is prominently displayed where first responders or other medical team members can easily find it.

            Forms vary by state, but are essentially POLST make your doctor Be able to specify which treatments are not to be used, under what conditions certain treatments can be used, how long they can be used and when they should be stopped. Issues covered in POLST may include:


            • Resuscitation Mechanical Ventilation Tube feeding
            • Using antibiotics
            • No request to transfer to the emergency room

            • Request not to be hospitalized
            • Pain Management

              A POLST also indicate which advance directives you have created and by whom as your healthcare surrogate. Like advance directives, POLST can be cancelled or renewed.

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                August . February 2, 2022

                1. Ask a Mayo expert. advance directive. Rochester, MN: Mayo Foundation for Medical Education and Research; 2017.
                2. AskMayoExpert. Do not resuscitate/do not intubate orders. Rochester, MN: Mayo Foundation for Medical Education and Research; 2016. Advance Care Planning: Medical health instructions. National Institute on Aging. Accessed 17 November 2018.
                  Peace of mind: Advance Care Planning. Centers for Disease Control and Prevention. Accessed 17 November 2018. FAQ: Advance Directives.American Cancer Society . Accessed 19 November 2018.

                  Healthcare Advance Planning Toolkit. American Bar Association. Accessed 2 October 2018. Myths and Facts about Advance Directives in Healthcare. American Bar Association. Accessed 2 October 2018. Living Wills, Healthcare Proxy and Advance Healthcare Directives. U.S. Attorney association. Accessed 2 October 2018. POLST is for professionals. National POLST paradigm. Accessed 19 November 2018. Patient FAQs. National POLST paradigm. Accessed 19 November 2018.

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