A Practical Guide to Creating Your Medical Directives
Creating your advance directives might seem daunting, but it can be broken down into a series of manageable steps. This is a process of thoughtful reflection and clear communication. Following this guide can help you create documents that truly represent your wishes.
Step 1: Reflect on Your Values and Wishes
Before you write anything down, take time to think. This is the most personal and critical part of the process. Ask yourself some deeply personal questions:
- What does a good quality of life mean to you? Is it being able to communicate with loved ones? Being free from chronic pain? Being mentally aware?
- What are your biggest fears about end-of-life care? Are you more afraid of dying, or of being kept alive in a state you would find unbearable?
- Think about different medical scenarios. If you were in a permanent coma with no chance of recovery, would you want to be kept alive with machines? What if you had a terminal illness and treatment would only prolong your life by a few weeks with significant side effects?
- Are there any religious or spiritual beliefs that shape your views on life, death, and medical treatment?
It can be helpful to write down your thoughts in a journal. There are no right or wrong answers; the goal is to understand your own preferences so you can articulate them clearly.
Step 2: Choose Your Healthcare Agent
Your healthcare agent will be your voice. This person holds immense responsibility, so choose wisely. Do not select someone simply out of obligation. Your agent should be:
- Trustworthy and Assertive: Someone who will respect your wishes, even if they personally disagree with them, and who can stand up to doctors or family members who might challenge your decisions.
- Calm Under Pressure: Medical crises are stressful. Your agent should be someone who can think clearly and communicate effectively during emotional times.
- Willing to Serve: Have an open conversation with the person you are considering. Ask them if they are comfortable taking on this role. Explain your wishes to them in detail to ensure they understand and are prepared to follow them.
- Accessible: Ideally, your agent should live nearby and be easily reachable in an emergency.
It is also essential to name an alternate agent. This is a backup person who can step in if your primary agent is unable or unwilling to serve for any reason.
Step 3: Talk to Your Loved Ones and Your Doctor
Once you have reflected on your wishes and chosen your agent, have open conversations with the important people in your life. Talk to your primary agent and your alternate. Share your values and the reasons behind your decisions. Give them a copy of your thoughts.
It is also crucial to talk to your family. Explaining your wishes now can prevent confusion, conflict, and guilt among your loved ones later on. While it may be a difficult conversation, it is a compassionate one.
Finally, discuss your wishes with your primary care physician. Your doctor can help you understand the medical implications of your choices and ensure your directives are consistent with your overall health goals. This conversation also helps ensure your medical team is aware of your plans.
Step 4: Get the Correct Forms
The legal requirements for advance directives vary by state. It is crucial to use a form that is valid where you live. You can typically find state-specific forms from several reliable sources:
- Your state’s bar association or department of health website.
- National organizations like the American Bar Association or AARP.
- Your local hospital or healthcare provider may offer forms and assistance.
- Non-profit organizations like Five Wishes offer documents that are legally valid in most states and also address personal, emotional, and spiritual needs.
While a generic form is better than no form at all, using one designed for your state ensures it will be legally recognized without issue.
Step 5: Fill Out and Execute the Documents Correctly
Be as clear and specific as possible when filling out your living will. Avoid vague terms like “no heroic measures.” Instead, state your specific wishes about treatments like ventilation, feeding tubes, and resuscitation.
To make your advance directive legally binding, you must sign it according to your state’s laws. This typically requires signing the document in the presence of two qualified witnesses. Some states may require a notary public instead of or in addition to witnesses. Read the instructions on the form carefully. Witnesses usually cannot be your healthcare agent, a relative, an heir to your estate, or an employee of your healthcare facility.
Step 6: Distribute and Store Your Documents
A medical directive is useless if no one knows it exists or where to find it. Once your documents are signed and executed:
- Give copies to your primary healthcare agent, your alternate agent, your doctor, and any close family members.
- Keep the original in a safe but easily accessible place. A fireproof box at home is a good option. Do not keep the only copy in a bank safe deposit box, as your family may not be able to access it in an emergency, especially outside of banking hours.
- Carry a wallet card that states you have an advance directive and lists your agent’s name and contact information.
- Consider uploading it to a secure online registry if one is available in your state.
For official information, consult government resources like USA.gov, the Consumer Financial Protection Bureau (CFPB), and the Federal Trade Commission (FTC).
