Few of us want to consider suffering a serious medical emergency and the potential end of our lives, as well as what type of medical care we’ll need and want at that point. Sadly, the COVID-19 pandemic has drawn attention to such situations and the importance of making decisions before you and your family may be forced to make difficult choices.
A document called an advance directive is the best way to ensure your wishes are followed, even if you can’t make medical care decisions for yourself. Without one, decisions such as whether you are kept alive by a ventilator or resuscitated could be made by a physician or by family members, who may not agree with your choices — or even with one another.
Jess Mauer, the executive director of the Maine Council on Aging, calls advance directives “one of the best things you can do for the ones you love.” That’s because it will be clear what type of care you want, or don’t want, and who you want to make critical decisions for you when you are not able to.
Advance directives are important at any age and time, but the spread of the coronavirus has brought more attention to them. Yet, only about one third of Americans have them.
Advance directives, also known as advance medical directives, essentially have two parts. One is to choose the type of care you want. Do you want life-sustaining treatment? Do you want a feeding tube? Do you want to be resuscitated?
You don’t have to answer these questions as part of the process.
The second part is to name the person or people you want to make health care decisions for you if you are unable to make such decisions for yourself. This is often called health care power of attorney.
It is important to have on-going discussions with family and others before and after you’ve filled out a directive. Make it clear what you value in terms of quality of life. The conversation project offers tips and tools for having these conversations, which can often be difficult to start.
There are three important things to know about advance directives. First, they can be completed for free. You can print or download a copy from the Maine Hospital Association and many other organizations. Make sure you use a form for the state of Maine.
Second, you don’t need a lawyer. Just print out a copy and fill it out.
Third, the form doesn’t need to be notarized, but you will need witnesses to sign the form. This can be done by family members, neighbors or friends, who, during this time of physical distancing, can watch you sign the form from a distance and then sign it with their own pen.
Once your form is filled out, make sure it is accessible. Giving a copy to your primary care physician is helpful. Giving copies to the people who you have named as decision makers is also a good idea. Also, make sure you have a conversation with the people you have named as decision makers.
An advance directive, which can be withdrawn at any time, does not give others power over all aspects of your life. It is just for medical decisions when you can’t make them yourself.
These directives should be reviewed from time to time, as medical care and your health change.
An advanced directive may never be used, but clarifying your priorities will remain a gift to your loved ones, said Robin Hirsh-Wright, the director of palliative care at Northern Light Home Care and Hospice.
“An advance directive prevents crisis-driven care at the end of life,” she said. It also saves family members and others from wondering if they made the right decisions.
For yourself, for loved one, begin this important conversation and fill out the readily available form.