We don’t often like to think about the end of our lives or the possibility of being so ill that we’re incapacitated — but being prepared can make a stressful situation less stressful for you and your loved ones. That’s where advance care planning comes in.
Advance care planning is the process of thinking and talking about future medical decisions if you had a sudden event, like an accident or illness, and could not make your own decisions. The best time to make these decisions is when you can choose for yourself. An advance directive helps you share those decisions.
What are advance directives?
We use the term “advance directives” to refer to several documents that will help the people caring for you understand your wishes. Advance directive documents allow you to give instructions to your health care provider if you can’t speak for yourself due to injury or illness. These documents don’t have to be complicated — they can be short, simple statements that express your values and choices.
Here are a few examples:
- Idaho Living Will: This document allows you to state your wishes about medical care in the event that you’re terminally ill or in a persistent vegetative state and can no longer make your own decisions. The Idaho Living Will becomes effective immediately once it is signed. It’s put into action once two doctors admit that a person is terminally ill and will die with or without the use of life-sustaining procedures, or that the person is in a persistent vegetative state. You don’t have to get this form witnessed or notarized.
- Health Care Directive: Unlike a living will, this directive isn’t limited to cases of terminal illness. If you can’t make or communicate your own decisions because of illness or injury, a health care directive allows you to keep control over the health care decisions that are important to you. You may state your wishes about any part of your health care, including decisions about life-sustaining treatment.
- Idaho Durable Power of Attorney for Health Care: This document lets you empower someone to make decisions about your medical care, including life support, if you can no longer speak for yourself. This document is especially important for unmarried people because it appoints someone to speak for you any time you’re unable to make your own medical decision, not just at the end of your life. This form does not have to be witnessed or notarized.
- Physician Order for Scope of Treatment, or POST: A POST is a document, signed by your physician, that expresses your treatment wishes. Your POST order will be followed by emergency medical personnel, medical care providers, and health institutions in Idaho. Your physician may get a POST from the Idaho Secretary of State’s website and clicking on “Health Care Directive Registry”; once the POST is completed, you may have it added to the State Health Care Directives Registry. For more information, visit the Idaho Department of Health and Welfare’s site.
- Patient Statements: You may give a verbal directive to your physician, but it must be documented in your medical record before it is considered valid.
How do advance directives work?
Once your advance directive is on file, St. Luke’s physicians and staff will honor and comply with it as long as the necessary physician orders are in place. If your advance directives create medical, ethical, or professional dilemmas among physicians, family members, nurses or other care providers, the St. Luke’s Medical Ethics Committee (or a comparable medical staff committee) will help consult.
Who should have an advance directive?
It’s worth filling out an advance directive if you are a “competent person” age 18 or older. (A “competent person” is defined as any person 18 years of age or older or any emancipated minor, as long as he or she is of sound mind). After 18, if you’re admitted as a St. Luke’s inpatient to the hospital, hospice, or home care, you’ll be asked about advance directives — the staff will want to know if you have one, or if you’d like to place your wishes in your medical file.
Advance directives might sound like they’re just for older people, but these documents are actually even more important for younger people. The stakes are higher: If you fall seriously ill or have an accident, you may be kept alive for decades in a condition you wouldn’t otherwise want. Advance directives can help your family and health care team understand what you want.
You aren’t required to complete advance directives, and you’ll be treated regardless of whether you have them or not. But we would encourage you to discuss your wishes with your family members and your physician so everyone is on the same page when the time comes.
What if I want to change my advance directives?
It’s easy. You can cancel or revoke your advance directives by issuing a new living will and durable power of attorney for health care, or you can write to the hospital or institution that holds it and state that it should be cancelled or revoked.
Don’t all advance directives mean “don’t treat”?
Not at all. Most people use advance directives to avoid being kept alive against their wishes when death is near, but that doesn’t mean all advance directives translate to “don’t treat.” Your advance directive could state that you’d like all possible, available treatments during your illness, for example. It’s really about expressing your personal values and wishes.
What happens if I don’t have advance directives?
If you don’t have one, you won’t be part of your health care decisions. By law, decision-making power will go to “surrogates” — usually, family members in order of kinship.
How can I put my own advance directives in place?
Review this Advance Care Planning Information prepared by Honoring Choices Idaho. It will help you understand your choices and consider them in light of the values and goals important to you. It also offers guidance on how to discuss your choices with your loved ones and health care providers; as well as instructions on how to complete appropriate forms and register them with the state of Idaho.
Where can I learn more?
For additional information or assistance in completing your advance directives, visit the following resources: