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New Year's Resolution: Do Your Advance Directives


If you haven't made a New Year's Resolution yet, I've got just the one for you. Everyone over the age of 18 needs Advance Directives: Living Will and Health Care Proxy (Durable Medical Power of Attorney).

Recently I was working with a family (husband and wife), and the husband got sick. He did not appoint his wife or anyone else as his health care proxy. When he was ill and needed medical attention, he refused to go to the hospital even though EMTs came many times to the house. There was nothing the wife could do but stand by and watch her husband suffer. He was losing oxygen to his brain and could not reasonably make good decisions; however, he could still answer the questions from the EMTs to determine if he was capable of making decisions at all. While everyone has the right to refuse medical care, the wife could have been instrumental in getting him pain relief earlier rather than later. Make sure you have someone you trust to carry out your wishes in the event you cannot do so. No one should be denied pain relief.

What is an Advance Directive?

Many people may have heard of advance directives and living wills but are still not quite sure what doctors are talking about when they mention advance care planning. Living wills and other advance directives are written, legal instructions regarding your preferences for medical care if you are unable to make decisions for yourself. Advance care planning refers to a whole process including reflection on what’s important to you in terms of quality of life; learning about options, such as palliative and hospice care; and having honest discussions with others, as well creating an advance care directive.

What is a Living Will?

A living will is a written, legal document that spells out medical treatments you would and would not want to be used to keep you alive, as well as your preferences for other medical decisions, such as pain management or organ donation. In determining your wishes, think about your values. Consider how important it is to you to be independent and self-sufficient and identify what circumstances might make you feel like your life is not worth living. Would you want treatment to extend your life in any situation? All situations? Would you want treatment only if a cure is possible?

You should address a number of possible end-of-life care decisions in your living will. Talk to your doctor if you have questions about any medical decisions.

What is a Health Care Proxy?

A health care proxy is a document that names someone you trust as your proxy, or agent, to express your wishes and make health care decisions for you if you are unable to speak for yourself. A health care proxy may also be called a durable medical power of attorney or an appointment of a health care agent or health care surrogate. Naming a proxy can help ensure that you get the health care you prefer in the event that you cannot communicate your wishes.

You do not have to be terminally ill to designate a health care proxy or for the proxy to make decisions on your behalf. Typically, your proxy will make treatment decisions whenever you are incapacitated and unable to communicate due to a temporary or permanent illness or injury. A doctor may have to certify that you are incapacitated before your proxy starts making decisions for you. Your proxy may also have access to your health records and other information, depending on the permissions you give them. If you want to place restrictions on what your proxy can do or see, you should include these in your health care proxy document.


Patti Urban, CSA, is the CEO of Aging Care Planning Solutions, an aging life care management company that assists the elderly and their families with advance care planning as well as guidance for patients with life-limiting illnesses. She is also a Certified End of Life Doula. She can be reached at

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