Advance Directives

Generally, an advance directive is a written statement which you complete in advance of serious illness about how you want medical decisions made. An advance directive allows you to state your choices for health care or to name someone to make those choices for you if you become unable to make decisions about your medical treatment. In short, an advance directive can enable you to make decisions about your future medical treatment. You can say "yes" to treatment you want or say "no" to treatment you do not want. The two most common forms of advance directives are:

• a "Living Will"
• a "Durable Power of Attorney for Health Care"

Below are some frequently asked questions regarding the Living Will and Durable Power of Attorney:

1What is a Living Will?

A Living Will generally states the kind of medical care you want (or do not want) if you become unable to make your own decision. It is called a "Living Will" because it takes effect while you are still living.

Most states have their own living will forms, each somewhat different. It may also be possible to complete and sign a pre-printed living will form available in your own community, draw up your own form or simply write a statement of your preferences for treatment. You may also wish to speak to an attorney or your physician to be certain you have completed the living will in a way that your wishes will be understood and followed.

2What is a Durable Power of Attorney for Health Care?

In many states, a "Durable Power of Attorney for Health Care" is a signed, dated and witnessed paper naming another person (such as a husband, wife, daughter, son or close friend) as your "agent" or "proxy" to make medical decisions for you if you should become unable to make them for yourself. You can include instructions about any treatment you want or wish to avoid. Some states have specific laws allowing a Health Care Power of Attorney and provide printed forms.

3Which is better: a Living Will or a Durable Power of Attorney for Health Care?

In some states, laws may make it better to have one or the other. It may also be possible to have both or to combine them in a single document that describes treatment choices in a variety of situations (ask your doctor about these) and names someone (called your agent or proxy) to make decisions for you should you be unable to make decisions for yourself.

4Do I have to write an Advance Directive under the law?

No. It is entirely up to you.

5Can I change my mind after I write a Living Will or Power of Attorney for Health Care?

Yes. You may change or cancel these documents at any time in accordance with state law.

Any change or cancellation should be written, signed and dated in accordance with state law.

Copies should be given to your doctor or to others to whom you may have given copies of the original. In addition, some states allow you to change an advance directive by oral statement.

If you wish to cancel an advance directive while you are in the hospital, you should notify your doctor, family or others who may need to know.

Even without a change in writing, your wishes stated in person directly to your doctor generally carry more weight than a Living Will or Durable Power of Attorney, as long as you can decide for yourself and can communicate your wishes. Be sure to state your wishes clearly and that they are understood.

6What if I fill out an Advance Directive in one state and am hospitalized in a different state?

The law on honoring an advance directive from another state is unclear. An advance directive tells your wishes regarding medical care. It may be honored wherever you are if it is made known. If you spend a great deal of time in more than one state, you may wish to consider having your advance directive meet the laws of both states.

7What should I do with my Advance Directive if I choose to have one?

Make sure that someone, such as your lawyer or family member, knows that you have an advance directive and knows where it is located. You might also consider the following:

• If you have a Durable Power of Attorney, give a copy or the original to your "agent" or "proxy."
• Ask your physician to make your advance directive part of your permanent medical record.
• Keep a second copy of your advance directive in a safe place where it can be easily found.
• Keep a small card in your purse or wallet which states that you have an advance directive and where it is located. Also state who your "agent" or "proxy" is, if you have named one.

Under the new law when you enter a Medicare or Medicaid hospital or nursing facility, receive home health or hospice care from a Medicare or Medicaid provider or enroll in a Medicare or Medicaid certified HIC/HMO, you should be asked whether you have an advance directive.

For further information, please ask those who are in charge of your care. You will also find additional information at Caring Connections , West Virginia Center for End-of-Life or Aging With Dignity , as well as links to the documents you need to complete based on the state in which you reside.

Find more information on a Behavioral Health Advance Directive.