Why Advance Directives Matter: Safeguarding Your Health Choices

Many people worry about the medical care they might receive if they become too ill to make their wishes known. There are many reasons you might not be able to speak for yourself in the hospital, including if you are unconscious, if medications or intubation restrict your ability to communicate or if you are confused due to illness, injury or medication. Your inability to communicate may be temporary, but important decisions might need to be made during that time.?

Advance Directives provide ways to share your medical care wishes while you are still able to make your own choices. In Ohio, we primarily talk about two types of advance directives: Healthcare Power of Attorney (HCPOA) and Living Will.?

Healthcare Power of Attorney

A Healthcare Power of Attorney, or HCPOA, allows you to pick who can help your treatment team with medical decisions if you can’t speak for yourself. An HCPOA allows you to name a primary and secondary person to participate in medical decisions on your behalf. The role of the HCPOA is to help with any decisions based on wishes you’ve expressed before, and based on your values, beliefs and goals.?

Anyone you trust can be your HCPOA, as long as they are a legal adult.

If you do not complete a HCPOA, then Ohio law states that, to help with medical decisions, the hospital must contact your next of kin (NOK) to participate in medical decisions on your behalf. NOK are contacted in the following order:?

• Spouse (by legal marriage)
• Majority of adult children available in a reasonable timeframe
• Parents
• Majority of adult siblings available in a reasonable timeframe
• Nearest adult related by blood or adoption.

HCPOAs can be a vital part of your healthcare planning. An HCPOA differs from a Power of Attorney or Durable Power of Attorney (POA or DPOA) which generally cover financial matters.?

Living Will

A Living Will communicates your end-of-life decisions if two doctors confirm that you are in a terminal condition or a permanently unconscious state. Living Wills allow you to indicate what kind of treatments you would or would not want, including nutrition, hydration and pain treatment. A Living Will should not be confused with a Last Will and Testament which gives direction on how you are managing your estate after death.

Who Needs Advance Directives? Why?

It is never too early to begin thinking about completing advance directives! Anyone who is 18 years of age and older with sound mind can and should complete this paperwork. Here are some reasons why:

• Advance Directives allow you to think ahead, typically around emergent or high-stakes medical situations, like accidents or unexpected illnesses.?
• Without Advance Directives, family members may be left questioning what you would want under incredibly difficult circumstances.?
• HCPOAs in particular give you the power to determine who speaks for you if you can’t speak for yourself. This is vital especially for people who would not want their next-of-kin to participate in their medical decisions.?
• Advance Directives are a gift to everybody involved because they help the treatment teams and your loved ones understand and follow your wishes.?

How do I complete Advance Directives?

You can get Ohio Advance Directive paperwork in many ways, including through a lawyer, through your doctor, through the internet or by following this link: summahealth.org/advancedirectives.?

You do not need a lawyer to fill out advance directives. You can follow the instructions on the documents and work with your doctor or loved ones.?

Advance directives need to be notarized or signed by two witnesses who are not named in the document and who are not blood relatives.?

What do I do once I complete an Advance Directive and it has been notarized or witnessed??

• Keep copies for yourself in safe places.?
• Give copies to loved ones, especially if you have named them as HCPOAs.
• Give a copy to your physician’s office; they can keep it and scan it into your electronic medical record.
• Bring a copy to the hospital if you are ever admitted; the hospital can also keep a copy and scan it into your electronic medical record.?

Most importantly, have conversations with the people you designate on these forms and with others you love and trust about specific medical decisions, but also your goals and values for medical treatment, life and death. You can also have these conversations with your healthcare providers. Take some time to talk to your loved ones and your care providers and to complete these documents so your wishes can be known, and your loved ones can advocate on your behalf with confidence.

Authors:

Kyle Yoder, D.O. & Ellen Saal-Patterson, MA, MSW, LISW-S