Advance Directives: Ensuring Your Wishes Are Followed

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The term “advance directive” encompasses all the legal documents that provide instructions for your medical care in the event that you cannot communicate your own wishes.

People often ask if living will the same as a healthcare power of attorney or a DNR order. Actually they are different, and a comprehensive advance directive can include all three.

These directives each deal with somewhat different decisions:

  • Living will: providing invaluable guidance to medical professionals in challenging times.
  • Healthcare Power of Attorney: ensuring your wishes are honored and decisions align with your values and beliefs.
  • DNR or POLST: outlining your choice regarding resuscitative measures in case of cardiac or respiratory arrest, expressing your preference for or against medical interventions.

A Living Will outlines your preferences for medical treatments if you become incapacitated and are unable to communicate. It includes specific instructions about:

  • Emergency medical interventions, such as CPR.
  • Life-prolonging interventions, such as artificial breathing, nutrition and hydration.
  • End-of-life care.
  • Related matters.

Healthcare Power of Attorney allows you to designate a trusted individual to act as your advocate in medical decision-making if you’re unable to do so. Unlike a living will, it allows your agent to address medical choices beyond those explicitly outlined. It covers:

  • Your healthcare proxy or agent.
  • When they can start making decisions for you.
  • Specific limitations about the decisions they can make.
  • Instructions on who can have access to your medical records.
  • Optional substitute proxies if your chose agent is unavailable.

A POLST and a DNR order are similar documents but with different scopes and purposes:

A DNR (Do Not Resuscitate) order specifically instructs healthcare providers not to perform cardiopulmonary resuscitation (CPR) if a person’s heart stops or if they stop breathing. It focuses solely on the CPR procedure and does not address other life-sustaining treatments or interventions, such as intubation, artificial nutrition, or antibiotics.

A POLST (Practitioner Orders for Life-Sustaining Treatment) is a more comprehensive document that goes beyond the decision regarding CPR. It covers a broader range of medical interventions and treatments

What makes POLST unique is its specificity:

It translates a person’s preferences into actionable medical orders regarding, including

  • Life-sustaining treatments.
  • Comfort measures
  • Optionally instructions about CPR, intubation, artificial nutrition, antibiotic use, and more.
  • Other medical interventions in emergency situations or at the end of life.

The POLST is designed for individuals with serious illnesses or frailty:

  • It complements other advance directives, like living wills or healthcare power of attorney.
  • It’s about providing clear, unequivocal instructions tailored to your healthcare preferences.
  • It is typically completed by a healthcare professional based on discussions with the patient or their surrogate decision-maker.
  • It is portable and recognizable across healthcare settings, ensuring continuity of care.
  • It is especially vital for individuals who want clarity on their healthcare decisions, providing guidance to healthcare providers in emergency situations where immediate medical interventions are required.
  • It aims to honor the patient’s wishes while respecting their dignity and

Creating an advance directive is a proactive step toward ensuring your voice is heard in medical situations where you may not be able to speak for yourself.

Remember: Having these documents in place can provide peace of mind and ensure your healthcare preferences are respected. Seeking professional guidance in drafting these documents ensures they accurately represent your wishes and comply with state-specific regulations.

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