It's Your Right

This information was obtained from the VA Ann Arbor Healthcare System. Even if you are not interested in this information at this time, you may want share it with your family.  I hope this information is helpful to you.

What is an Advance Directive?

An Advance Directive is a document that helps your doctors and family members understand your wishes and choices about healthcare. It can help them decide about treatments if you are unconscious or too weak to talk.  An Advance Directive can be:

1. A Durable Power of Attorney for Healthcare and / or
2. A Living Will.

What is a Durable Power of Attorney for

Healthcare?

A Durable Power of Attorney for Healthcare allows you to choose a person to act on your behalf to see that your wishes are carried out only if you become unable to make your own decisions.

This person may be:

1. Your spouse
2. An adult child over the age of 18
3. A close relative
4. A trusted friend
5. Your attorney
6. Your minister, priest, or rabbi
7. Any person you trust to act on your behalf

What is a Living Will?

A Living Will contains written instructions that tell your family and doctor what kinds of treatments you would or wouldn't want if you became ill and couldn't decide for yourself.  It clearly shows your own beliefs and values about the medical treatment and care you want for yourself.

A Living Will clearly shows your own beliefs and values about medical treatment and care you want for yourself.

Who can sign a Durable Power of Attorney for

Healtcare and/or Living Will?

Anyone over the age of 18 is of sound mind (competent) can sign a Durable Power of Attorney for Healthcare and /or Living Will.

Can I still make my own choices and decisions about my healthcare once I have an Advance Directive?

Yes!  You have the right to make your own healthcare decisions as long as you are able to do so.

When does an Advance Directive take effect?

Your Advance Directive becomes effective only when you are not able to express your own choices or own healthcare decisions.

What situations and decisions do people commonly face with regards to health care decisions?

1. If you are unconscious, in a coma, or in a persistent vegetative state and there is little or no chance of recovery.
2. If you have permanent severe brain damage (for example, severe dementia) that makes you unable to make healthcare decisions.
3. If you have permanent condition that makes you completely dependent on others for your daily needs (for example, eating, bathing, toileting).
4. If you are confined to bed and need a breathing machine for the rest of your life.
5. If you have pain or other severe symptoms that cannot be relieved.
6. If you have a condition that will cause you to die very soon, even with life-sustaining treatments.

What are some examples of the medical treatments about which I can state my choices on my Living Will within my Advance Directive?

1. CPR (Cardiopulmonary Resuscitation)
2. Breathing machine (mechanical ventilation)
3. Kidney dialysis
4. Feeding tubes (artificial nutrition and hydration)
5. Medicines to fight infection (antibiotics)
6. Cardioversion (electric shock to restart heart)
7. Surgical procedures, operations
8. Diagnostic tests
9. Intravenous (IV) line
10. Chemotherapy and/or radiation

Additionally, there is a section in the Living Will where you can write any other additional preferences about your health care that are important to you and that are not described any where else in the document.  These may include your preferences about how you would like to be cared for.  For example, you might have clear opinions about whether you would want a particular treatment (for example, a feeding tube, blood transfusions or medications to maintain or stabilize your blood pressure).  You might want to comment on treatment of pain or whether you would want life-sustaining treatments on a trial basis.  Or you might want to write about your preferences regarding treatment of mental illness.

Who should witness you signing your Advance Directive?

You should sign and date your Advance Directive in the presence of two witnesses.

The witnesses can be:

1. Friends
2. Neighbors
3. Social workers
4. Others:  Non-clinical VA employees of the Chaplain Service, Psychology Service, Medical Administrative service, Voluntary Service or Environmental Management Service may also serve as witnesses.

Once I have completed and signed an Advance Directive, what should I do with it?

You should give a copy to:

1. Your social worker, doctor, or the clinic/ward staff (to be kept with your VA records)
2. Your representatives in the Durable Power of Attorney for Healthcare
3. Your family
4. Yourself.  Also keep a list of all people who have copies and keep a copy that is readily accessible

Can I revoke, cancel or change my Advance Directive?

Yes, you may change or cancel your Advance Directive at any time by telling your family, doctor, nurse, social worker, chaplain or healthcare provider.  You should review your Advance Directive periodically, especially if there are any changes in your health, to make sure it is up to date.  If you change it, be sure to tell your health care team and have them put it in your health record.  Share your new Advance Directive with your family members and loved ones.