What are Advanced Directives?

by Wendy, Retirement Enthusiast/Coach

This seminar was presented by the Final Exit Network and is written from my notes at the CSA conference.

What are Advanced Directives?

Do you have an Advanced Directive? The Patient Self Determination Act of 1990 (enacted in 1991) allowed us to document our care wishes for use if and when a medical incident happens and we cannot make our own decisions.

DEFINED: The Advanced Directive is a legal document that states a person's wishes about receiving medical care if that person is no longer able to make medical decisions because of a serious illness or injury.

What does Quality of Life mean to YOU?

This is not just about death, but about life after a serious medical issue.

Two documents make up the Advanced Directive. Please be sure your wishes are spelled out clearly.

  • Health Power of Attorney
  • Living Will

    Does someone know where your paperwork is located? If they can't find your documents, someone may decide for you.

    We had paperwork already on the hospital system before my stepdad entered the hospital for the last time. However, they asked us to bring in the original paperwork towards the end. Don't assume that staff already looked it up — maybe not.

    Choosing your Surrogate

    You choose surrogates to speak for you; they know your wishes written in the paperwork. Otherwise, you have no control over what happens to you.

    Your surrogate must be willing to do this job. This might be your spouse, but not necessarily. They need emotional strength to make difficult decisions. They need to ask questions so the decision is understood. You'd hope they'd remain calm with others who are more emotional around them. This is a heartbreaking time of life so choose your surrogate wisely.

    Chat with your appointed surrogate to ensure they are ready and willing to do this for you. Go through your document to explain your wishes so they know what you want instead of making assumptions later.

    You should have a Plan B — a second available surrogate in case the first isn't available. Two surrogates aren't good, as you'd suspect they might have different opinions, but you do need a second choice.

    Why Not eliminate the possibility of others making decisions about our life and death, when we could have that ability done before anything is needed?

  • Sudden Accidents (like car accidents)
  • Sudden Death (gone early without leaving directions)
  • Medical Incidents (maybe become brain dead and you might be kept in limbo for years as they go through legal systems)

    Get Advanced Directive Form online (if you don't already have this from your attorney):

    AARP Advanced Directives are printable State forms which are often long and complex.

    Five Wishes has Advanced Directives which are easier. They charge $5 for paper copies and $10 for online Directives.

    Review your Advanced Directive

    You should review your paperwork periodically. You may no longer have contact with your named surrogate, or maybe everything is still good. It's simply a good practice to review every few years for changes. Life changes.

    Initial and date the document when reviewed to prove it's still valid. That way, nobody can say "Hey, he did this 20 yrs ago!" Videos are easy enough nowadays and family members can hear you voice your wishes.

    Supplemental Advance Directive for Dementia Care (SADD)

    This surely must be the most feared diagnosis. My mother has had dementia for years but it only progressed during COVID isolation. My stepdad had it longer and was

    The Final Exit Network has a PDF on SADD available to learn more about SADD.

    RESOURCE: Final Exit Network is a great place to learn all you need about death and dying options. This isn't a topic we like to discuss but doing the right thing, making your wishes known, is always best for family in the long run.

    F.E.N. also has a Surrogate Consultant Program where they can review records with the patient. They will layout options with no advice. They offer support and answer your questions.

    P.S. The home page of this site mentions that FIFTEEN new cases of ALS are diagnosed daily in the U.S. I didn't know that. My cousin, Randy, thought he had long-termer COVID months after he was better — he slurred his words suddenly, sounding like he'd had a few drinks. Months later, diagnosed with ALS. They had a few months to get their affairs in order… never realizing how quickly his ALS would progress. He died within a year in 2022. He was lucky to have a husband by his side until the end. In his early 70s, Randy was wealthy, well-traveled, enjoying all life had to offer — and BOOM. RIP Randy!

  • Comments for What are Advanced Directives?

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    a few answers...
    by: nick/philadelphia

    Lots of questions...a few simple answers. The easiest things to do is have a will and a living will created by a lawyer and file it with the city/county, etc. Then tell some people about your wishes and where your will is available.

    For the most part, you can request DNR (do not resuscitate) and/or to be denied food/water under certain circumstances.

    My lawyer said it's a good idea to write out any additional wishes and keep them available to someone as well. You can get good blank legal documents online which normally are just as good but potentially more risky.

    Like many other things, the situation can often be handled in the moment...like for a spouse, etc, the medical staff will likely just ask.... My children know my desires very will...

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