Have you thought about what you would want to be done medically in an emergency if you could not speak for yourself? It may not be a subject that you enjoy thinking about. But knowing you’ll receive the care you want can give you peace of mind. Having your wishes documented in an advanced directive can be helpful.
What is an Advanced Directive?
An advanced directive is a legal document, which states your medical preferences in case you are unconscious and unable to communicate your wishes. It helps ensure you get the medical care you want. It can also prevent futile treatment you don’t want. An advanced directive is also useful to avoid disagreements and confusion among family members.
Do you Need an Advanced Directive?
An advanced directive is not just for people with a chronic disease, such as pulmonary fibrosis. It’s also not just for the elderly. Accidents and unexpected situations can happen to anyone, regardless of their age and state of health. An advanced directive is a good idea for all adults over 18.
What’s Included in an Advanced Directive?
Typically, an advanced directive often contains a living will, which lets your health care team know what treatments and life-saving measures you want and what you don’t want. The information included in an advanced directive can be detailed or limited.
In an advanced directive, you can name a durable power of attorney for your healthcare decisions. If you do name a healthcare proxy, it only goes into effect if you cannot make decisions about the care you want, such as if you become incapacitated or unconscious.
An advanced directive may have detailed instructions and may include your wishes on the following:
CPR: CPR involves chest compressions, which is combined with manual ventilation to assist with breathing. Medications and defibrillation may also be used along with CPR. You can state in your advanced directive whether you want CPR performed if your heart stops.
Mechanical ventilation: Mechanical ventilation is needed in cases of respiratory failure to replace or assist your spontaneous breathing. Patients require the assistance of a ventilator for varying amounts of time.
Artificial nutrition: Artificial nutrition is a medical treatment that involves administering fluids and nutrition if you are not able to take it by mouth. Artificial nutrition can be administered by putting a tube in the stomach or intravenously.
Dialysis: Kidney dialysis may be required in cases of renal failure. Sometimes dialysis is temporary until the kidneys can function again. In other cases, kidney dialysis may be needed long-term.
Organ donation: If you wish to donate your organs, this can also be stated in your advanced directive.
First Steps in Advanced Directives
If you are interested in drawing up an advanced directive, there are a few things you may want to do, including:
- Preview the forms. It may be a good idea to look at the forms approved by your state as legal advanced directives. Forms by state can be accessed here. 5 Wishes is also a common document used in several states. Reviewing these forms may bring up questions and situations you hadn’t previously thought of.
- Speak with your doctor. If you are unsure about what certain life sustaining measures involve, it’s important to get accurate information from your doctor.
- Take some time to think about your wishes. Drawing up an advanced directive takes some thought. Spend time thinking about what determines quality of life for you and what treatments you are willing to consider.
- Talk to your family. Although your loved ones do not have to agree with your health care decisions, it’s helpful if they know your wishes.
- Consider meeting with a lawyer. A lawyer will be able to answer your questions and make sure your document is drawn up according to the laws of your state.
- Keep copies of your advanced directive somewhere that is easily accessible. If you named a health care power of attorney, make sure he or she has a copy of your advanced directive. An additional photocopy can be given to your doctor and a local hospital.
Content written by Dr. Jeremy Feldman, an expert in Idiopathic Pulmonary Fibrosis, with contributions by MaryAnn DePietro, B.S. CRT, a licensed respiratory therapist.