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Advance Directives

Advance Directives Resources

Advance Directives Resources

Advance Care Planning

Advance care planning is making decisions about the care you would want to receive if you become unable to speak for yourself. These are your decisions to make, and should be based on information about your health status provided by your clinicians and on your personal values, preferences and discussions with your loved ones.

You don't have to be ill or elderly to do advance care planning. But if you do have a serious medical condition or are in failing health, our staff will assist you and your family in learning what is necessary about your condition and prognosis to make informed decisions. Your healthcare team, which may include doctors, nurses, social workers and chaplains, will answer questions and provide guidance to help you create a plan that will help to ensure that your care is appropriate and effective and consistent with your wishes and preferences.

Although discussions regarding end-of-life care can be difficult, advance care planning provides a number of benefits to you and your family. It helps ensure that you receive effective, appropriate care and eases decision-making for you and your family at the end of life. Other benefits of advance care planning include:

  • A better understanding of your illness, prognosis, treatment options and possible outcomes
  • An opportunity for you to state your wishes for end-of-life care
  • A plan of care that includes your goals and preferences
  • Creating advance directives that explains your plan of care

If you or your loved one is seriously ill, our caring staff will be there for you and your family every step of the way.

Advance Directives

Advance directives are legally enforceable documents, initiated by you, that outline the type of care you want, especially at the end of life. Advance directives usually include two documents:

  • A durable power of attorney for healthcare that names someone whom you trust to act on your behalf in the event that you can no longer make your own healthcare decisions.
  • A living will that allows you to indicate the type of medical treatment that you would or would not want to receive if you cannot communicate your wishes and you are terminally ill.

Advance directives do the following:

  • Document your wishes and preferences
  • Relieve the decision-making burdens for your loved ones
  • Allow you to choose someone you trust to make decisions about your care
  • Prevent the delivery of unwanted medical and surgical treatments
  • Give you peace of mind and a sense of control

Even if you aren't terminally ill or elderly, advance directives are useful to have in case of a sudden accident or illness. You can give copies of your advance directive to family members and your doctor, and you can bring a copy to the hospital if you become a patient.

Our chaplains, social workers and other staff are available to help you and your family work through the decisions necessary to complete advance directives. They can also assist you in creating the documents you need.

You can change your advance directives at any time. When you change your advance directives you must create a new form, distribute new copies and destroy all old copies. You should always discuss changes with your primary healthcare professional to make sure the new document replaces the old one in your medical file. You should also make sure the new document is added to medical charts in a hospital or nursing home.

Living Will

A living will is a legal document that details your decisions on issues such as pain management, organ donation or medical treatments you would or would not want doctors to use to keep you alive when you have been diagnosed with a terminal illness or are in a permanently unconscious state.

In creating your living will, take into consideration your values, the value you place on the quality of life versus the length of life, and under what circumstances you would or would not want your life prolonged. It's important to talk with your primary care doctor, healthcare agent, family and friends about your personal wishes for:

  • Resuscitation
  • Mechanical ventilation
  • Tube feeding
  • Use of dialysis, antibiotics or antivirals to treat end-of-life infections
  • Comfort care (palliative care) to manage pain
  • Organ and tissue donation
  • Donating your body for scientific study

Durable Power of Attorney for Healthcare

A medical or healthcare power of attorney allows you to name a person to make healthcare decisions for you when you are unable to make them for yourself. It can also be called durable power of attorney for healthcare or a healthcare proxy.

The person you choose to hold power of attorney might be your spouse, an adult child, another family member or a friend. You may also choose one or more alternates in case your first choice is unable to fulfill his or her role. It is important that the person you choose:

  • Meets your state's requirements for a healthcare agent
  • Is not your doctor or a part of your medical care team
  • Is willing and able to discuss medical care and end-of-life issues with you
  • Can be trusted to make decisions that support your wishes and values
  • Can be trusted to be your advocate if there are disagreements about your care

Pennsylvania Orders for Life-Sustaining Treatment (POLST)

A Pennsylvania Orders for Life-Sustaining Treatment (POLST) is a medical order signed by a clinician that documents end-of-life decisions made collaboratively with the patient. POLST can only be executed after discussions with your healthcare providers; while advance directives, including a living will, can be executed with or without such a discussion. A POLST is designed to be portable, meaning that the order applies regardless of whether you receive care at home, at a nursing facility or at a hospital. POLST is especially well suited to the needs of individuals who have a limited life expectancy (e.g., of one year or less).