What You Need to Know About Advance Directives

According to a national poll conducted by the University of Michigan, only 46% of adults aged 50 to 80 have an advance healthcare directive. This means over half of all older adults don’t have any legally binding way to tell doctors or healthcare workers their wishes. In addition to a will, an advance directive (also called a living will) is one of the most important estate planning documents you should have in place.

This stat is not that surprising, but it is scary since an advance directive is so important - especially as we age. And you can even do the paperwork yourself:

https://www.oregon.gov/oha/ph/about/pages/adac-forms.aspx

If you’d like to speak with an estate planning attorney about the ins and outs of advance directives reach out to us at Felling & Reid, LLC to discuss your options. From our office in Albany, Oregon, we’re able to represent clients throughout Polk, Lincoln, Marion, Benton, and Linn counties.

So What is an Advance Directive (Living Will)?

An advance directive is a legal document that allows an individual to spell out their wishes for end-of-life care and medical interventions should they become incapacitated or unable to communicate. This could cover circumstances such as becoming so seriously injured that you can’t speak or write, falling into a coma, becoming terminally ill, or developing severe dementia, Alzheimer’s, or other cognitive impairments. In all of these cases, though you’ll still be technically alive, you may not be legally able to communicate with your doctors and loved ones.

When you’re preparing a living will, you’ll try to address any potential medical emergency that can come up. For example, it can cover decisions related to what kind of life-saving treatments you want, whether you want to be put on a ventilator, whether you want to be tube fed, whether you want to donate any of your organs, or whether you want any antiviral or antibiotic medications administered.

Health Care Representative

As part of your directive, you’ll have to appoint a health care representative (also called a medical power of attorney or a proxy) who will be able to make medical decisions on your behalf using their own best judgment or following the guidelines you’ve already laid out. Even the most comprehensive advance directive will never be able to include every potential situation, so it’s essential you choose someone you can trust to act in your best interests and make decisions that are in line with your values.

A representative is typically someone you know well, such as a family member or close friend. This person cannot be a doctor or nurse that’s already part of your healthcare team. Whomever you choose, you should have in-depth discussions with them about their role and your expectations of them. You can also appoint an alternative representative should something happen to your first choice.

Do Not Resuscitate (DNR) Directive

Anyone who has ever watched a TV medical drama knows about DNRs - do not resuscitate order. This essentially tells medical staff that you do not want them to perform cardiopulmonary resuscitation (CPR) on you should you stop breathing or your heart stops beating. This type of form is not part of the advance directive and usually needs to be signed by a doctor for it to be legally binding. However, even if you don’t have this document as part of your living will, you can still tell your doctor at the hospital and they are legally obligated to include this in your medical chart.

POLST (Physician Orders for Life-Sustaining Treatment) 

Similar to a DNR, but more comprehensive in its directives, is a POLST (Physician Orders for Life-Sustaining Treatment). This may also be called a Medical Orders for Scope of Treatment (MOST) or a Medical Orders for Life-Sustaining Treatment (MOLST). This document is only used for people who have already been diagnosed with a serious illness and is added onto an existing advance directive instead of replacing it. It will contain specific instructions related to your disease such as what medical interventions you do or do not want, what kind of facility you’d want to be transferred to, or what kind of pain management you’d like. No matter what kind of healthcare facility you’re at (for example, a hospital, hospice care, long-term care facility, or even at your own home), your POLST will stay with you and should be posted next to your bed so any health care provider will be able to reference it.

Making Modifications to Your Advance Directive

It’s always best to draft an advance directive as soon as you can, and this should preferably be done while you’re still relatively young and healthy. That way, you can continue to add to it or modify it as you age and as your needs change. This link can get you started, no attorney required!

https://www.oregon.gov/oha/ph/about/pages/adac-forms.aspx

Skilled Legal Guidance At Every Stage

If you’re in the Albany, Oregon area and would like to talk to an experienced attorney about any aspect of estate planning, please reach out to our team at Felling & Reid, LLC.