Why You Need an Advance Directive

Advance directives address the things we try not to think about. They plan for the worst-case scenario; when you are alive, but unable to pass on your wishes for treatment or life-prolonging measures.

They make sure your wishes are passed on; however, sometimes people don’t have them in place when they need them. This article will teach you everything you need to know about advance directives, how they help, and why you should have one in place.

An advance directive is a document that explains what type of health care you do or do not want in case of a situation in which you are unable to make your own decisions. Studies have shown that while 80 percent of Americans would rather pass comfortably in the safety of their own homes, 60 percent die in acute care hospitals, 20 percent in nursing homes, and only 20 percent at home. With the advancements in medical technology, most people who would have died at home 100 years ago are now able to be kept alive and might end their lives lying in a hospital bed hooked up to machines.

For most people, this is not how they want their life to end, yet if that is not passed on, health care professionals will do what they can to lengthen life through technological medical means. A lot of people see death as being delayed through these technologies, making it a painful, expensive and emotional experience for family and loved ones. Witnessing a loved one who is in a permanent vegetative state can lead family members to question whether the individual would have wanted to be kept alive yet unable to communicate.

An advance directive works to solve these problems by giving specific instructions as to what someone will want in the case that they are incapacitated and are unable to speak for themselves. There are two main types of advance directives: a living will and a health care power of attorney. 

Living Will

The oldest form of the advance directive is the living will. A living will deals primarily with end-of-life concerns. You can outline what types of treatment you wish to receive if you at the end of your life, and this document goes into effect when you are no longer able to communicate.

Your health care team is required to follow the directives that are detailed in your living will, and your physician will decide when you are unable to make your own medical decisions, and are not expected to gain that ability back.

A living will could address:

• Resuscitation: If your heart stops beating do you want either CPR or electric shock to restart your heart? 

• Mechanical Ventilation: If you have stopped breathing do you want to be hooked up to a machine that breathes for you? And if so, for how long? 

• Feeding Tube: Do you want to be fed through a tube that supplies nutrients and fluids if you are unable to eat? And if so, for how long? 

• Dialysis: Do you want your blood filtered through a machine if your body is unable to do this? And if so, for how long? 

• Antibiotics: If you are unresponsive, do you want medication to be used to treat infection? 

• Comfort Care: Outlines the palliative care you will want to keep you comfortable and pain-free if you are unable to speak for yourself. 



• Organ Donation: Outlines whether you want to donate organs or tissues and specifies if you will allow to be kept on life-sustaining devices while organs are harvested. 

Getting specific in your living will help to avoid confusion later on. It will also help your family members make those hard decisions regarding your treatment. 

Health Care Power-of-Attorney

A Health Care Power of Attorney (HCPA) is for all health care decisions, not just end-of-life ones, and will only last while you are unable to make decisions for yourself. An HCPA can be used as well to gain access to medical records, and to put you in a facility to receive care.

An HCPA will assign an agent who will perform your wishes for you, and can be as detailed as you described it to be. Both a living will and a HCPA can be changed or dismissed at any time as long as you are mentally competent and able to do so. 

How Does an Advance Directive Help? 

If you happen to leave your family and loved ones with no clue as to what your medical wishes are, it can leave them being very confused and scared on what to do in case you become unable to communicate. They may feel hesitant as to what you would want done, or they may think that you would wish to not to be kept alive by a machine but they feel too guilty to try to advocate for that. Think about your family spending years caring for you in a vegetative state—and consider what instructions you could do give them to avoid that situation.

An advance directive can bring comfort to the individual making it, knowing that they will not put stress with their families and friends with difficult decisions if they happen to become physically incapacitated. An advance directive also helps family members have the confidence and peace that they are going along with their loved one’s wishes. 

Who Needs an Advance Directive? 

Simply put, everyone. You need be 18 years or older to create an HCPA, living will, or advance directive, and you must be able to think reasonably. No one can force you into making a document describing your wishes. If you are over 18, having an advance directive in place that you revise and possibly change over time makes sure that if any sudden tragedies occur, your family and loved will know exactly how to handle your decisions regarding your end-of-life care or life-prolonging measures. Most people are cautious to make these types of documents due to the subject matter making them uncomfortable, but the consequences of having no documentation in place should scare them anymore. 

As you grow older, the reality of these situations becomes more and more of a reality, but sudden tragedy can happen at any time. Counseling with an attorney with an expertise in elder law can help bring clarity to your health care planning and help you figure out what documents you need. Don’t neglect to create an advance directive, doing so as soon as possible will bring peace to you and your family. 

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