August 11, 2010
What are advanced directives?
Though most people have a clear idea in their heads about how they want to be treated when the end finally comes, only about a quarter of Americans have these ideas written down. “Advance directives” is a term that refers to two types of documents, a ‘living will‘ that codifies what measures you would like taken, if any, to prolong life, and a ‘health care proxy‘ and ‘power of attorney’ that designates who should be empowered to make decisions for you if you are unable to for yourself. These documents can be called by different names in different states, and some states have particular requirements (please refer to our state by state list for laws relevant to your state). For legal help in completing these documents, please contact a local elder law attorney. You can search for one in your area by visiting the National Academy of Elder Law Attorneys website: www.naela.org.
Why are advanced directives so important for someone with Alzheimer’s disease?
It is important to consider the possibility of dementia when making these directives. You have the right to make decisions regarding your medical care, including the right to accept or refuse treatment. The course of action you would want taken if you were to get pneumonia while able to make decisions for yourself may not be the same course you would want taken should you no longer be in control of your mental powers. Do not leave your loved ones to guess what you would have wanted, or to argue amongst themselves. Write it down. Give a copy to each immediate family member and a copy to your doctor.
Advanced Directives and Medicare:
Healthcare facilities/agencies are required to discuss advance directives before admittance, and the Conditions of Participation and the Conditions of Coverage for Medicare also require patients to be asked about advance directives when they come to healthcare facilities, so having them prepared beforehand will make admittance easier.
Where can I get free information on advance directives?
- American Bar Association: Tool Kit for Health Care Advance Planning; 10 Legal Myths About Advance Medical Directives
- American Health Lawyers Association: Guide to Legal Issues in Life Limiting Conditions
- American Hospital Association: Put It In Writing
- Caring Connections: Advance Care Planning; Financial Information; Planning Ahead Checklist; Free Brochures
- Center for Practical Bioethics: Caring Conversations Workbook (resources available in Spanish) Caring Conversations is a workbook to help individuals and families communicate with each other about their healthcare preferences and contains advance directive documents. These forms are valid in every state when notarized and signed by two witnesses. Download for free or call 800.344.3829 to order.
- National Association of Social Workers: Advance Care Planning and Psychiatric Advance Directives. More information is available about Psychiatric Advance Directives at the National Resource Center on Psychiatric Advance Directives.
- Aging with Dignity (charges small fee): Five Wishes (resources available in Spanish) The Five Wishes document helps individuals express care options and preferences. The advance directive meets the legal requirements in most states and is available in 20 languages for a nominal fee. Order online or call 850.681.2010.
Where can I get advance care planning documents?
- Project Grace: Print an Advance Directive (resources available in Spanish) Project Grace offers a free Advance Care Planning Document that is legally valid in states that do not require forms to be notarized. Download for free, or call 877.99.GRACE to order a copy.
- Lifecare Advance Directives: The Lifecare Advance Directive website offers free state-standard advance directives for all 50 states, the District of Columbia, and four major United States territories (American Samoa, Guam, Puerto Rico, and the Virgin Islands). Research validated comprehensive advance directives, as well as completion guides, agent guides, and other important advance directive support documents are also available for a small fee.
- Cremation or burial services: A conversation with your family on healthcare decisions should include a frank discussion on how you would like your remains handled. If you would like Cremation, check with your state to find out if your expressed desire is enough, or if you need the consent of your next of kin. The International Cemetery, Cremation and Funeral Association offers a “Model Cremation Authorization Form,” which you can modify to comply with the legal requirements of your state.
- MedicAlert Foundation: The MedicAlert Foundation offers an array of Do Not Resuscitate jewelry and an option for storage of advance directives.
Where can I get information specifically rejecting euthanasia?
- The Will to Live Project: The Will to Live Project provides state specific forms for designating an agent and stating healthcare wishes. “The Will to Live form starts from the principle that the presumption should be for life.”
- International Task Force on Euthanasia and Assisted Suicide The International Task force offers a durable power of attorney document (in either multi-state or state-specific versions) that expressly defines and prohibits euthanasia.
State by State Resources for pre-planning:
- Florida Agency for Health Care Administration- Health Care Advance Directives
- The Florida Bar (Forms)
- New Hampshire
- New Jersey – Department of Health and Senior Services
- New Mexico
- New York
- West Virginia
Articles in this section of www.ALZinfo.org are written by professional journalists and individuals who strive to present reliable, up-to-date information. However, personal decisions regarding health, finance, exercise, and other matters should be made only after consultation with the reader’s physician or professional adviser. Opinions expressed herein are not necessarily those of the Fisher Center for Alzheimer’s Research Foundation.