April 13, 2023

Prepare for Your Future with Advance Directives


If you suddenly became ill and unable to communicate, who would make healthcare decisions on your behalf? To remind adults of all ages about these important questions we must all address,  April 16 is National Healthcare Decisions Day (NHDD). The aim of NHDD is to “inspire, educate and empower the public and providers about the importance of advance care planning.”

Advance directives are a big part of NHDD. These documents ensure that your values and preferences are at the center of any medical care you receive.

What is advance care planning?

Advance care planning is a process of thinking, talking, and deciding about future healthcare decisions. Specifically, it helps your loved ones understand what is important to you in case they need to make medical decisions for you. A As Honoring Choices Pacific Northwest explains, “Talking with your loved ones and healthcare providers is the best way to make sure your voice is at the center of your healthcare.” Completing the proper legal and medical forms will ensure that your care follows your wishes.

What is an advance directive?

Advance directives are legal documents that outline your instructions on the type of medical care you want. They only go into effect if you cannot make decisions about your own healthcare. There are two types of legal documents that are usually used as an advance directive, either separately or together:

  1. With the durable power of attorney for healthcare, or DPOAH, you name a person you trust who would be authorized to direct your care. This healthcare agent or “proxy” would make decisions only if you cannot. Often, the DPOAH also includes additional information, like what your spiritual beliefs are, what a good day looks like for you, or what brings you comfort. It’s good to name both a primary healthcare agent and a couple of alternatives so that someone is always available to advocate for you.
  2. The healthcare directive is often called the living will. This document lets you pre-select decisions for common life-sustaining medical treatments. In Washington state, these choices only apply if you are permanently unconscious or not expected to recover. An example of choice would be if you would like artificially provided nutrition and hydration.

Often, the portable order for life sustaining treatment (POLST) is included in the discussion about advance directives. Unlike the legal documents listed above, the POLST is a medical order that alerts emergency and other providers about your preferences on cardiopulmonary resuscitation (CPR), artificial nutrition, and the general level of treatment you want.  The POLST is not intended for healthy people; it is primarily for the seriously ill or frail regardless of age.

How to get started

The best way to start is to think about what is important to you. Knowing how you want to live will inform what medical choices might be best for you.

Talk about your decisions  with your loved ones and medical providers. Don’t forget to ask your doctor questions if you want more information about options like CPR. Then, either start the written documents or revisit what you’ve already completed. Often hospitals or clinics can provide DPOAH and living ill forms to fill out. Prepare for Your Care is an online resource that has documents that are legal in all 50 states and video guidance as well.

Sources: The Conversation Project; Honoring Choices Pacific Northwest; National Institute on Aging; National POLST; Prepare for Your Care

Categories: Resources