Advance Directives

Definition

Advanced care directives are specific instructions, prepared in advance, that are intended to direct a person's medical care if he or she becomes unable to do so in the future.

Alternative Names

Power of attorney for Healthcare; DNR; Do not resuscitate; Living will

Information

Advanced care directives allow patients to make their own decisions regarding the care they would prefer to receive if they develop a terminal illness or a life-threatening injury. Advanced care directives can also designate someone the patient trusts to make decisions about medical care, if the patient becomes unable to make (or communicate) these decisions.

Federal law requires hospitals, nursing homes, and other institutions that receive Medicare or Medicaid funds to provide written information regarding advanced care directives to all patients upon admission.

Advanced care directives can reduce:

• Personal worry
• Futile, costly, specialized interventions that a patient may not want
• Overall health care costs
• Feelings of helplessness and guilt for family
• Legal concerns for everyone involved

However, advanced care directives cannot predict what situations may arise in the future or what new modes of care may be available for situations considered nearly hopeless today.

Summary

The process of creating advanced care directives may be difficult. It requires you to think about your priorities regarding quality of life and your death. Treatment options, and their possible influence on your quality of life, need to be fully understood and considered. Know the potential implications of choosing or refusing specific forms of care.

Discuss your wishes regarding advanced care directives with your health care providers, family members, and friends. Review your wishes from time to time to remind everyone.

Download Form

The State of Maryland offers a form to do this planning. The form as a whole is called "Maryland Advance Directive: Planning for Future Health Care Decisions." This publication also includes a frequently asked questions section (pp. 5-6) that you may also find informative.