July 9, 2021
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Differences Between Types of Advanced Healthcare Directives

Discussing the setting up of Advanced Healthcare Directives is not the most comfortable or pleasant conversation to have with your aging loved ones. The conversation can be initiated by discussing your personal decision to get all your affairs in order due to the uncertainty of the times. This can open the conversation to encourage them to do the same.

Assure your loved one that this will be a sure way of having his or her values and beliefs respected. Without heartfelt conversation among family members concerning advanced medical directives, the best-written form in the world will be of little value. The worldwide outbreak of the coronavirus pandemic has made it urgent and easier to approach this sensitive subject. This is just one of the many challenges your parent will face when aging in place.

What Does Advanced Healthcare Directives Mean?

Power of attorney is one of the advanced healthcare directives

Advance Medical Directives fall into three categories:

  1. Living Will
  2. Power of Attorney
  3. Health Care Proxy. 

These are legal documents in which a patient (primary individual) expresses how medical decisions are to be made if they are incapacitated. 

The document (legal instrument) also tells medical staff who have been authorized to speak on behalf of the patient. 

It outlines the kind of treatment the person would want to be administered to them in the case of need if they are unable to speak for themselves . It also describes the type of medical procedures they do not wish to be performed. So it can be thought of as a planning and communication tool. 

The person setting up the advanced healthcare directives needs to make sure that the trusted authorized person or people will accept the responsibility and is willing to carry out the patient's decisions if he/she is incapable of doing so. 

The primary individual will also want to ensure that the person chosen to be their spokesperson has a strong enough personality and can follow through on their wishes. If you do not believe you would be the best person to perform this task, suggest someone who may be a better fit.

The medical directive needs to be properly witnessed by two or more people, dated and signed.  

A copy of the completed medical directive will then be kept on file at your loved one's doctor's office and given to everybody involved. 

You might want to suggest mom keep a miniature copy of her medical directive in her wallet or purse. This will help her indicate that she has an Advance Medical Directive in place. 

What Should Be Included in an Advanced Directive?

This will include decisions as to what the person will expect in the form of where he \ she would like to live during this time, the kind of medical treatment preferred, and in the case of death, whether the body should be cremated or buried, or if the organs should be donated.

The medical directive can authorize more than one person to be the patient's decision-maker. 

Bear in mind that an Advanced Medical Directive can be changed as your feelings and choices evolve, although you will want to make sure that all role players are made aware of changes and given a new copy. 

Medical information is always changing, so you want to make sure that your loved one's wishes are relevant and in line with present medical advances and State regulations.

This can be started with the wording, "If the time comes…, I will not want any measures taken to extend my life and will want to die naturally",  

Advantages of Having an Advanced Medical Directive

Living will is one of the advanced healthcare directives.

Due to the unpredictable nature of illness and injury, it is wise to help mom put this legal document in place now for everybody's peace of mind. 

This takes family members off the hook because arguments among close family members about the best medical treatment can cause deep and lasting divisions, resentment and guilt. 

Though uncomfortable to think about, making sure your elderly loved one has these documents in place will make sure their desires are carried out. This also takes the burden of very difficult decisions off of the family at a time when stress is high and emotional states make sound decision making nearly impossible.

Health care professionals' mandate in the case of an emergency is to keep their patient alive unless advanced directives specify otherwise. Therefore, the medical staff would have to do everything in their power even though at times this might not give the patient a better quality of life. 

Are there Advanced Directives for Mental Health?

In the case of individuals with a new diagnosis of a progressive mental disease such as Alzheimer's Disease or Dementia, it is important to get advanced directives in place quickly. This will allow your loved one to make their own decisions related to their future medical care.

While it is difficult to think and talk about, it really is important. Putting off these difficult decisions is not helpful and may make them more challenging due to the progressive nature of the disease.

These diseases can be identified early if you know what to look for. If you are concerned about your loved one's memory or problem solving, it is a good idea to bring this up as soon a possible with their primary care provider. It may just be normal effects of aging, but it is best to find out.

Our parents will often resist these conversations with the doctor as it is difficult to face the thought of declining cognition. It will likely be helpful to attend the doctor's appointment to be sure of the questions asked and the doctor's response.

It is still a good idea to put plans in place for advanced healthcare directives. A living will, healthcare proxy or power of attorney may be the correct option.

The proxy directive will be the individual chosen by the patient to be her spokesperson but limits invasive medical decisions. Here too, an Advance Directive Medical can be changed if the patient so desires, but you need to bear in mind that this type of directive only remains valid for three years at last count.  

Which Advanced Healthcare Directive is Suitable for Someone Who Cannot Speak for Themselves?

Health care proxy is one of the advanced healthcare directives.
Healthcare Proxy Form

Let's take a look at two options that cover these:

  1. Health Care Proxy: This allows the designated person to make medical decisions if you can't speak for yourself, although it limits the proxies' decision to allow the administration of invasive medication to save the person's life. Without a health care proxy in place, it can take a long-drawn-out court case which takes time and money to direct your health care treatment. An Advanced Medical Directive referred to as a "Living Will" designates invasive measures like artificial life-prolonging care, feeding tubes, CPR, or antibiotics. 
  2. Power of Attorney: Power of Attorney is the authority given to you to act on behalf of another person in all specified or all legal, financial, and medical matters. This will provide the designated person with the legal right to make medical decisions that will impact your life significantly, which is usually given to a living spouse. Here you once again need to be sure that your spouse will be guided by your decisions and will not be overridden by sentiment. 

Where can documents be obtained?

Any drawn-up form is a legal document as long as it has your signature and date on it witnessed by two or more people. 

Advanced Medical Directives can also be found online, but bear in mind these will be planning tools only, yet it is useful for getting started. In addition, forms can be found in your doctor's office, hospitals and senior centers; you need to make sure that your document is State approved. 

If you wish to download a directive, you might want to try Samaritan Healthcare that boasts its form is acceptable in 42 States; it is called "Five Wishes - A Living Will Document". It states its objective as letting your doctors and family know: 

  • Who you wish to make healthcare decisions at a time you can't make them. 
  • The kind of treatment you like or don't want. 
  • How comfortable you want to be. 
  • How you want people to treat you. 
  • What you want your loved ones to know. 


In summary, the three main reasons for an Advance Medical Directive is to [1] nominate a person, [2] leave specific instructions [3] share your particular values and wishes. 

We have looked at Alternative Directives that might vary in nature due to the type of illness issues the patient might experience. 

Extra care and consideration must be exercised when setting up a Medical Directive for a person with a progressive disease that effects cognition such as Alzheimer's or dementia. 

This relieves family members and friends of guilt, conflict and animosity over medical issues and decisions. It leaves you with the peace of mind that your loved one's wishes concerning values and beliefs will be respected. 

Be aware of each state's differing requirements, and you are off to a peaceful state of mind.

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That's all for today.

Take care, keep mom safe and have a great day!


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