Advance Healthcare Planning or Advance Care Planning is a method to ensure that you get the best medical treatment even when you are incapable of expressing yourself due to any illness or injury. Mr. Arnold, 53 years old, talked with TrulyWill that he wants to plan his Advance Healthcare Plan because he does not want outside interference in the medical treatment even if he is bedridden and debilitated.
Surprisingly, an Advance Healthcare Plan is assumed to be a document used by older people only, but that’s not true. Life is unpredictable and you are never too young to have your affairs and assets managed.
What is the Advance Healthcare Directive?
Advance Healthcare Directive is a collection of different legal documents. It allows you to give directions or appoint a person to act on your behalf if any unanticipated situation arises that leaves you incapable of expressing the consent and wish concerning the medical treatment and care to be given to you.
Who is eligible to make Advance Healthcare Directives?
The person who makes an Advance Healthcare Directive is called a Testator.
Anyone is eligible to make Advance Healthcare Directives, if
- He has attained the age of majority, i.e., 18 years old, and
- He is a sound-minded person.
Old age or disease is not the requirement a young and perfectly healthy person may plan regarding his health care in advance.
Types of Advance Healthcare Directives
The different types of Advance Healthcare Directives are used for different purposes.
1. Living Will
Living Will is a legal document that states all your desires and will to get the best medical treatment to prolong your life if you become debilitated or incapacitated by any disease or accident. However, it is different from the Last Will. A Living Will may also include the wishes for the funeral and its expenses or other relevant details.
2. Medical Power of Attorney
A Medical/Healthcare Power of Attorney (POA) is a legal document like Living Will. A POA legally authorizes the third person who is trustable to give consent and directions regarding end-of-life or medical/critical care of the testator on his behalf. Like an agent is appointed to act on behalf of the principal concerning his medical treatment. A person authorized to act on behalf of the testator is called Attorney in Fact.
Who is eligible to be the Attorney in Fact?
A person legally authorized in the Medical Power of Attorney (POA) to make decisions on behalf of the testator is called the Attorney in Fact. The eligibility criteria for appointing an Attorney in Fact (AIF) are different in the states of the US.
So you keep in mind that you are fulfilling the criteria adherence to the laws of the state you belong to while appointing the AIF, along with the following conditions:
- The person must be an adult and sound-minded.
- Trustable to adhere to your wishes and intentions.
- Trustable to defend you if there’s any disagreement about your medical care.
- He wanted to be your Attorney in Fact of his own free Will to take care of your health affairs.
- But he should not be your doctor or one of the caretakers.
Other names for Attorney in Fact
- Authority Proxy
- Health-care Proxy
- Health-care Agent
- Health-care Surrogate
- Health-care Representative
- Patient Advocate
3. Advance Directive
When a person chooses to make a Living Will, along with the Medical POA, these two legal documents become an Advance Directive.
Advance Directive is a comprehensive document comparing Living Will and Medical Power of Attorney. It doesn’t leave any scope for carelessness about the medical care and treatment of the testator.
One can only make an Advance Directive for himself, not for the benefit of their family, friends, loved ones, etc.
Living Will prevails over POA, always. The directions in the Living Will supersede the directions by the Attorney in Fact for the effective implementation of the Advance Directive.
4. Psychiatric Advance Directive
Psychiatric Advance Directive (PAD) is a legal document just like the Advance Directive but made for mental healthcare. That’s why the other name for the PAD is the Advance Directive for Mental Healthcare.
PAD lets you decide on the mental health treatment you would prefer to get if in the future you are unable to communicate your wish or desire due to paralysis, stroke, injury, ailment, etc.
Other Healthcare documents and forms
These documents are neither the Advance Care Plan in literal terms nor are replacement for Advance Healthcare Plan but it functions together with the Advance Directive for better implementation of the instructions given by the testator.
A physician’s Order for Life-Sustaining Treatment is different from an Advance Directive. POLST Form is a document filed by the testator and his doctor for an emergency to outline the medical treatment plan subsuming CPR (Cardiopulmonary Resuscitation) and artificial feeding tubes to elongate the lifespan.
If you are wondering when is the right time to complete the POLST Form, then the first thing you are required to prepare is your Advance Healthcare Plan. Keep it updated. As and when you are diagnosed with a deadly ailment or disease, you need to complete a POLST Form with the help of your doctor. POLST Forms come into force when there’s an emergency.
POLST Forms are advisable for terminally or seriously ill and reaching the end of life. A POLST Form requires it to be signed by the doctor. However, emergency personnel can refer to a POLST Form for your treatment but not an Advance Directive. The filling of the POLST Form has not been incorporated into rules by all the states. The requirements of 50 states.
Like POLST Forms, Do Not Resuscitate Order is used by patients with deadly disease or irreversible coma. But DNR requires the doctor to sign that the testator (the patient) does not want to get CPR but rather would have a natural death. Instead of CPR, the patient would like to opt for other potential emergency treatments:
- Intubation means inserting the breathing tube
- Chest compression
- Defibrillation means giving electric shocks to the heart
- Mouth-to-mouth breathing technique
POLST Form is a more detailed document than DNR, as DNR only gives instructions if CPR is to be given or not when breathing or heart beats stops.
Different names for Advance Healthcare Directives in different States
The States use different names for Advance Healthcare Planning documents. Some States use Advance Directive and Living Will, interchangeably.
Below is the list of the States where a Living Will is called as the Advance Directive or Advance Healthcare Directive or Advance Directive for Health Care:
The remaining States use Living Will Declaration or simply Declaration etc., for a document of Living Will.
What to do before planning an Advance Healthcare Directive
Now that you know what the Healthcare Directive is and its types, think about which document fits your requirements.
- Talk to your Doctor
Get a full-body checkup if you have been diagnosed with any health condition then your doctor will help you in suggesting the best Medicare you should write in your Healthcare Plan. If you do not have any serious health issues right now, your doctor can help in planning future risks.
- Choose a suitable document
The prerequisite of Advance Healthcare Planning is to know what medical treatment and care you prefer or do not prefer. There are different legal documents for various purposes, choose a document which is suitable for you. Choose Living Will for giving direction concerning the medical care and treatment, a Medical POA to appoint an agent on your behalf to take care of your health-related affairs, or an Advance Directive for broader coverage of risk.
- Know what to include
The third step is to know what decisions you have to make in case of an emergency. As in the first step you have already consulted your doctor, he must have suggested some treatments to prolong your life in a medical crisis such as Cardiopulmonary Resuscitation which is used to restore the heart beats, or Artificial Nutrition or Hydration when you are fed through a feeding tube as you are not in a condition to eat, or using Ventilators to rescue and help you breathe.
As these treatments are not always successful, the decision should be made according to age, gender, immunity, bearing, and other health issues. Sometimes people choose an end-life-care or comfort care for themselves.
- Need a lawyer
The last step is to take a hand from a lawyer if you want. But it is not a requirement or mandatory. Nowadays you can make a Living Will, POA, or any other Healthcare Directive online very easily at an affordable cost. You must be now pondering over if online Wills are valid, the shortest the answer to this question is yes.
What to do on completion of the Advance Healthcare Directive?
Once you have completed the Advance Healthcare Plan, it should be made official. Every state has its sanctions and different Advance Healthcare Directive forms. Some states want it to be notarized, some require witnesses at the time of making a Healthcare Plan. You may take help from TrulyWill to choose the correct form.
The bigger step is to make up your mind, knowing your needs and wishes, and the document that fits your requirements. After that, only some formalities are left. Give copies of your Advance Healthcare Plan to:
- Your doctor
- Family and close friends
- Your healthcare agent/proxy/Attorney in fact
- The staff, if you have to go to the hospital
- Registries of your State, if that’s a requirement
- Lastly and most importantly, carry it with you or just a card with your Healthcare agent’s contact details
If you are someone who travels from place to place or lives in one state more than the other state, then use the Advance Directive forms for each State. This might look overwhelming but it will benefit you and rescue you from many unanticipated medical situations where you are unable to make your wishes conveyed.
Keep revising and updating your Advance Healthcare Plan from time to time and also keep the above-mentioned people updated about it.