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End-of-Life Decisions Part I: Living Wills and Advance Directives

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Most people have heard the terms “living will” and “advance directive.”  If you have had surgery or any other type of medical procedure in the last 20 years, it is highly likely you had a conversation with medical personnel about having a living will or advance directive in place prior to the procedure.  Both living wills and advance directives are written legal instructions that state a person’s preferences for medical care should they become unable to make decisions for themselves.   The documents are often accompanied by a medical or health care power of attorney (POA).   A POA is a specific advance directive that empowers a named person to make medical decisions for an individual when he or she is no longer able to make them for him or herself.   

Your Denver nursing home attorney explains that in Colorado, the correct terminology is “medical durable POA” and a “declaration as to medical or surgical treatment.”  Regardless of what they are called, it is important to name a POA because simply having a living will does not ensure your treatment decisions will be implemented.   Furthermore, not all medical situations can be anticipated, so the POA must be someone who knows you well enough to make decisions that adhere to your wishes and values.   The POA must be trusted to advocate for you if there are disagreements regarding your care, and he or she must be willing and able to discuss medical care and end-of-life issues.

What Should Be Included in the Documents?

Your Denver nursing home attorney notes that a living will should include a person’s philosophical feelings regarding extending life, i.e.  whether and under what circumstances does the person want his or her life to be extended.  A few extending life or sustaining life scenarios that should be specifically considered are: resuscitation, ventilation, tube feeding, dialysis, palliative care, and organ and tissue donation.   For some types of interventions, a specific order can also be included or stand alone,  such as a DNR order, which is a Do Not Resuscitate order or a DNI order, which is a Do Not Intubate order.   

Living wills and advance directives are particularly helpful in scenarios where patients are in comas or persistent vegetative states, have severe brain injuries, suffer from strokes, have advanced Alzheimer’s disease or dementia, or have any other critical medical illness that affects their mental capacity.   A living will or advanced directive takes the burden off the family and medical team by allowing them to follow the patient’s own decisions as to what care they do and do not want to preserve their life.

Although living wills and advance directives are most often associated with the end of one’s life, such documents can help clarify a person’s treatment in the earlier stages of a disease or medical condition.   Thinking through a person’s whole treatment process and goals makes it easier to make decisions regarding treatment options in the later phases of the disease or condition.   

If you would like more information on living wills, medical durable power of attorneys, and advance directives, contact Jordan Levine at the Levine Law Firm today.