What You Should Know About Advance Directives

It’s valuable information most people neglect to share: What are your wishes for medical care if you can’t make decisions for yourself?

It can make us uncomfortable to think about these things. But in the event that you are unable to express your wishes, it’s important to guide your loved ones and medical professionals when important decisions about life-sustaining treatment must be made.

By planning ahead, you can get the medical care you want and relieve caregivers of decision-making burdens, confusion and disagreements during moments of crisis or grief.

Advance Directives allow you to clearly document your wishes for end-of-life medical care.

There are three main types of Advance Directives: a Health Care Proxy, a Durable Power of Attorney and a Living Will.

Here’s what you need to know:

Health Care Proxy

A Health Care Proxy (HCP) is a legal document that allows you to name someone you know and trust to make your health care decisions, if, for any reason and at any time, you become unable to make or communicate those decisions.

This person is referred to as your "Health Care Agent,” and can be completed without an attorney or notary. Any competent adult 18 years of age or over can be your health care agent. Your health care agent will be able to:

• Make decisions about your health care when you can't.
• Consent to or refuse any medical treatment.
• Get any medical information necessary to make informed decisions for you.

It is important to be sure your agent knows what is important to you. You should tell your agent your beliefs and wishes regarding:

• Where you want to be cared for
• What caretakers you want
• Your family involvement
• Your religious beliefs
• Financial concerns
• When or when not to prolong your life
• Pain or suffering
• Organ donations

You should let your agent know your feelings about certain forms of medical treatments, such as:

• Life-sustaining treatment
• Cardiopulmonary resuscitation (CPR)
• The use of intravenous therapy and/or feeding tubes to administer food, water or medicine
• Breathing machines
• Kidney dialysis

To download a Health Care Proxy Form, visit the Massachusetts Medical Society website or call the South Shore Health System Care Line at 781-624-8888.

Durable Power of Attorney

A medical or health care power of attorney is a type of advance directive in which you name a person to make decisions for you when you are unable to do so. In Massachusetts, this legally binding directive is also called a Durable Power of Attorney for health care or a health care proxy.

The person you name may be a spouse, other family member or a friend. Whomever you choose, he/she should meet the following criteria:

• Meets your state's requirements for a health care proxy
• Is not your doctor or a part of your medical care team
• Is willing and able to discuss medical care and end-of-life issues with you
• Can be trusted to make decisions that adhere to your wishes and values and be your advocate if there are disagreements about your care

Living Will

A Living Will is a written, legal document that clearly outlines medical treatments you would and would not want to be used to keep you alive. In Massachusetts, a Living Will is not considered to be a legally-binding document. However, it is an important tool for doctors and your healthcare proxy, who can use it as a guide to manage your care.

Your Living Will should address a number of possible end-of-life care decisions including resuscitation, mechanical ventilation, tube feeding, palliative care, organ and tissue donations and thoughts on donating your body for scientific study.

When you can’t make health decisions for yourself, Advanced Directives can speak for you, guiding your loved ones and doctors in the right direction.

Read more about Advanced Directives on our South Shore Health website.