Overview
An Advance Directive is an important tool in planning for and participating in your health care. The information set out below about that planning process comes from materials developed by Martha Jefferson Hospital and the University of Virginia Health System, in Charlottesville, Virginia. Their materials in turn were adapted from Respecting Choices, a program developed by Gunderson Lutheran Hospital in LaCrosse, Wisconsin. They recommend that you follow these steps:
Recommended Steps
First, Understanding...
1. that you have the legal right to set out, ahead of time, the health care to which you consent and the health care to which you do not consent in the event that, in the future, you become incapable of giving informed consent to treatment;
2. that you also have the right to choose someone as your agent to make decisions for you about your medical care, consistent with the instructions that you give;
3. that Virginia law enables you to do this through an Advance Directive
4. that you can modify your Advance Directive, or revoke it, at any time before you are reach the point where you are no longer able to make informed decisions about your care
Talk to your doctor so you understand your current health condition, potential consequences of this condition, treatment options and their benefits and risks.
Second, Reflecting...
On medical choices in light of your values, your spiritual beliefs, your particular situation.
On your personal goals, both medical and non-medical.
On the experiences of family and friends who were unable to communicate their choices.
On what it means to you to “live well”.
On who you trust to speak for you (your agent). When choosing this person, pick:
1. someone who is willing to speak on your behalf
2. someone who knows your preferences & values
3. someone who will honor your wishes even if they would want a different choice
4. someone able to function in difficult situations, to be a strong advocate for you
Third, Discussing...
With loved ones, trusted friends, clergy, or members of your faith community.
With doctors, nurses, and other health professionals.
With the person you trust to speak for you if you cannot speak for yourself (your agent).
Clarify what certain words mean to you (for example, If you say “no heroics,” what do you mean?).
Fourth, Preparing Your Plan...
Use an updated advance directive form to legally document your choices regarding your health care and/or your selection of an agent. Be sure it is properly signed, dated, and witnessed.
Provide guidelines about treatment choices. You may use the same advance directive form or may also write a letter or other document to attach if you want to provide more guidelines.
Talk to your agent and/or write down your thoughts about what you think is a “reasonable” trial of a treatment, pain/symptom management, home or Hospice care.
Talk to your family members about your wishes--especially those who might disagree.
Carry a wallet card telling emergency workers where a copy of your advance directive is.
Fifth, Giving a Copy of Your Written Plan To...
Your health care agents.
Your family and close friends.
Every doctor who takes care of you.
Your hospital. If you don’t expect to be a patient soon, take a copy to your hospital to keep on file. Keep a list of the people who have copies in case you want to change your directive.
Sixth, Continuing the Process...
Once a year or if your health changes, look at your written advance directive to see if it still matches your goals. If your agent’s health changes or if you change your mind about your wishes or your agent, complete a new advance directive.
Remember that advance care planning lets you make your wishes known in case you are temporarily or permanently unable to make decisions for yourself.