When Do Healthcare Directives Apply?

When Do Healthcare Directives Apply?

January is a month of promise and hope. Fresh from our New Year’s resolutions, we feel emboldened and empowered to achieve our goals. We feel energized and ready to get organized, to complete projects, and to be more proactive in life.

 

Woman working on healthcare directive

Photo courtesy: DepositPhotos.com/choreograph

One of the projects that might be on your list is completing your healthcare directive. If you’ve been reading my blog or have heard me speak, I trust you have been inspired to start having family conversations about your future healthcare wishes—and then complete this critical document.

A great place to start is to understand the context when healthcare directives apply.

Your healthcare directives apply if you are ever unable to make or communicate your own healthcare decisions.

In an emergency, if you are unable to make choices or communicate your treatment preferences, decisions for your care will be made:

  1. By your healthcare agent(s) who are listed in your legally executed healthcare directive
  2. Based upon your healthcare instructions in your directive or a POLST documented in your medical chart. Click here to learn about the POLST.
  3. By the medical team in conjunction with loved ones based upon what they believe is best for you, if there is no healthcare directive or POLST available.

 


Your healthcare preferences might differ in various situations, based on the medical circumstances you are facing.

In order to express your medical decisions most clearly, it is helpful to understand the medical circumstances in which your directive would most likely be exercised—if you were unable to make or communicate your own medical decisions. Not all circumstances can be anticipated. Nonetheless, most legal healthcare directive forms or tools typically reflect three broad and significant circumstances when healthcare directives apply. Consider the level of medical care you would desire if you were:

  1. Terminally ill or injured—Your primary (or attending) doctor and another qualified doctor have decided that you have an irreversible, incurable condition from which you will not recover.
  2. In a persistent vegetative state—Your primary (or attending) doctor and another qualified doctor agree that, within a reasonable degree of medical certainty, you can no longer feel anything, knowingly move, or be aware of being alive. You have been in this state for at least four weeks. They are qualified to make this diagnosis, believe this condition will last indefinitely without hope for improvement, and have observed you long enough to make that decision.
  3. Permanently unconscious—Your primary (or attending) doctor and another qualified doctor agree that, within a reasonable degree of medical certainty, you can no longer feel anything, knowingly move, or be aware of being alive. You have been in this state for at least one year. They are qualified to make this diagnosis, believe this condition will last indefinitely without hope for improvement, and have observed you long enough to make that decision.

In your healthcare directive, you can also choose to address some or all of the following circumstances by specifying your treatment preferences if you were:

  • Suffering from advanced dementia—Your primary (or attending) doctor and another qualified doctor agree that you have an irreversible brain injury or a progressive brain disease from which you will not recover, and that you have reached an advanced state of dementia or memory loss where you are permanently unable to communicate, recognize your loved ones, care for yourself, eat, and drink by yourself.
  • Dying from a progressive disease such as amyotrophic lateral sclerosis (A.L.S., also called Lou Gehrig’s disease) or some forms of multiple sclerosis—Your primary (or attending) doctor and another qualified doctor agree that you have a progressive disease from which you will not recover, and that you have reached an advanced state where you are permanently unable to communicate, care for yourself, eat, and drink by yourself.
  • Extremely frail from aging, and have been admitted to the hospital for a common affliction or injury—Death is not always triggered by disease. Our bodies can simply wear out. Through your healthcare directive, you can exercise your right to limit or refuse treatment in this circumstance.
  • Temporarily incapacitated from an accident or sudden medical event—Although healthcare directives are most commonly applicable for end-of-life care, a directive can be immensely helpful to your medical team and your healthcare agent if you should temporarily lose the ability to make or communicate your own decisions.

 


You can change your instructions at any time as long as you are cognitively capable to make and communicate your decisions.

I am often asked, “What if I change my mind about my treatment preferences?” Many people do change their minds through the end-of-life journey. Reflecting upon your preferences through the process of writing your healthcare directive can prepare you for future decisions. Nonetheless, knowing you’ve communicated your preferences in your healthcare directive will give you peace of mind if you are ever unable to express your wishes.

QUESTION: If you or a loved one have written a healthcare directive, would you please share your story and inspire others via social media? Please share this post with your comment.


WORRIED ABOUT DECISIONS FOR MOM OR DAD?

 

You can prepare for the responsibility of serving as the healthcare agent for one or both of your parents.

This FREE guide will help you to prepare for the future possibility of making medical and personal care decisions for your Mom or Dad. Interested?

Click here to download your copy

 

Healthcare Agent Preparation Guide

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