Advanced Care Directives – the What, Why & How

Benjamin Franklin once said, “In this world, nothing can be certain except death and taxes”. Neither subject is pleasant to dwell on but we must be prepared for these inevitable events.

WHAT is an advanced care directive? Basically an ACD (advance care directive) is any adv care dirwritten or discussed instruction, discussed in advance, concerning any aspect of a person’s healthcare. Common documents include: living will, designation of healthcare surrogate, organ/tissue donation, preplanned funeral arrangements, etc.

The most common document is a Living Will. A Living Will is a legal document used to designate a person’s medical decisions concerning life-prolonging procedures when the person is incapacitated or unable to speak for himself or herself.

WHY bother with Advanced Care Directives?   Today the leading cause of death in America is chronic or progressive diseases (heart disease, cancer, pulmonary disease, etc.).   Most people are concerned with quality of life, not just longevity. Have you ever said “I wouldn’t want to live like that….”, of course you have.

It's Your LifeMedical school teaches how to save lives, not how to tend to their demise. With technology and medical advances there is always one more treatment to be tried; too often the treatment causes more harm than good.

For an excellent, eye-opening look into the medical profession vs. aging and dying, read Being Mortal by Atul Gawande.

Advanced Care Directives are not just for the aged and those with incurable disease. Karen Quinlan, Nancy Cruzan, and Terri Schiavo each were in vegetative states and each case ended up in a court room for a decision whether or not to terminate life support.

No instruction, no directive is a decision – difficult choices left up to family, and sometimes the court, can rip apart a family forever.

HOW – 4 easy steps

Step 1.   Consider who you trust to carry out your wishes no matter how difficult it may be toimages-15 do. Someone who can stand up against the medical profession eager to prolong life and possibly face the challenges of family members who may not agree with your decisions.

Step 2.  This is perhaps the most uncomfortable step. Talk. Discuss. Let family members know who you have appointed to speak for you should you not be able to. I highly recommend the document Five Wishes, it does not replace a Living will but it will help you identify your wants.

Step 3.  This step is easy, probably the easiest. Get the forms, they are free. is a wonderful resource and will help you find state specific forms.

Step 4.  Last but not least, distribute copies to the designated person or health care surrogate, your doctor and keep a copy in your home.

Take action now, before tragedy or illness strikes. Just do it.

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