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Step-by-step: preparing an advance directive

What good is your advance directive if it's locked away where no one can find it? If something happens, you want to be sure your wishes are known. © iStockphoto.com What good is your advance directive if it's locked away where no one can find it? If something happens, you want to be sure your wishes are known. © iStockphoto.com

By Gregg Newby, Staff Writer, myOptumHealth

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No one likes to think about a terminal illness or serious injury. But if you're not careful, your final health care decisions could end up in the hands of complete strangers. The best way to avoid this is with an advance directive. This document gives written instructions to caregivers, telling them the kind of care you want. And though they are usually associated with older adults, it's a good idea to have one at any age.

Creating an advance directive is not hard to do, though it may take some time. It's probably worthwhile to consult an attorney, because your state may have specific guidelines in place.

Here's how you go about it.

1. Decide what you want. There are many questions to consider when it comes to end-of-life planning. If you are terminally ill, seriously injured or become unable to make decisions for yourself:

  • Do you want to be resuscitated?
  • Do you wish to be on life-support?
  • Do you want a feeding tube or IV fluids?
  • Do you want to be in a hospital or at home?
  • Do you want to be an organ or tissue donor?

Though these are the major ones, there are plenty of other things to consider as well. How you answer them is up to you. Even so, it might be a good idea to have a frank discussion with your loved ones before you commit anything to paper. It may help you think through the process more thoroughly. Talk to your doctor, too, if you are unsure about any of the medical choices you are making.

2. Appoint health care and financial representatives. Once you've made your decisions, you'll need someone to act on your behalf. This is the person who ensures that caregivers carry out your written instructions. You appoint them by granting them "Durable Health Care Power of Attorney" and/or "Durable Financial Power of Attorney." This may be a complex process in some states, so you may want to get an attorney to help you complete it.

You can appoint one person to oversee your medical care and grant another the power to act on your behalf on money matters. Or if you prefer, you can ask the same person to fill both roles. The person you appoint will have access to your medical and/or financial records. So, you'll want to choose someone who is trustworthy and responsible.

3. Put it in writing. Your wishes won't mean much if caregivers can't read them. For that reason, take the time to write out your instructions. In most cases, a handwritten statement is legally valid, although you can easily find a blank template to use online, too.

There may be some other things you want to put in writing as well:

  • If you don't want CPR, make sure your medical records have a do not resuscitate (DNR) order.
  • Update your driver's license to show if you're an organ or tissue donor.
  • Complete a HIPAA privacy form that allows your health care representative to view your medical records.

4. Make it official. There are a couple of ways you can give your advance directive some extra legal standing. One is to sign it in front of two witnesses. The other is to have it stamped by a notary public. Notarization isn't normally required. But it could help your document stand up in court later on.

5. Distribute it. What good is your advance directive if it's locked away where no one can find it? If something happens, you want to be sure your wishes are known. That's why you should make multiple copies and give them to:

  • Your attorney
  • Adult family members who will be affected
  • Your primary physician
  • Trusted friends

Have your attorney place a copy on file, to be accessed whenever it's needed. Also ask your doctor to put one in your medical records. That way, other health providers can see it too. In fact, this may be the most important step of all. Having an advance directive that caregivers can't read is no better than having none at all.

View the original Step-by-step: preparing an advance directive article on myOptumHealth.com 

SOURCES:

  • American Bar Association. Living wills, health care proxies, and advance health care directives. Accessed: 03/17/2010
  • American Bar Association Commission on Law and Aging. Legal guide for the seriously ill: Seven key steps to getting your affairs in order. Accessed: 03/17/2010
  • Nolo. The living will and power of attorney for health care: an overview. Accessed: 03/17/2010

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