Although many people find it difficult to talk about serious illnesses or life-threatening emergencies, it’s important to make sure your physician and loved ones know about your medical care wishes before you are faced with a serious accident or illness and unable to speak for yourself. That’s where Advance Directives can help.
Advance Directives provide you with the tools you need to help you tell others about your wishes regarding treatments such as resuscitation and life-support machines. Your goal is to take some of the burden off your family by making your wishes known.
Types of Advance Directives in Texas
The most common types of Advance Directives are the following:
Directive to Physicians
Sometimes called a living will, this is a written, legal document that clearly states what types of medical treatments and life-sustaining measures you do and do not want. These can include being placed on a ventilator (a machine that breathes for you), feeding tube, surgery, etc. In Texas, you may name a Medical Power of Attorney in your Directive to Physician. The document may also be called a health care declaration or health care directive.
Medical Power of Attorney
This is a legal document that allows you to designate someone to make medical decisions for you, if you become unable to do so. The person you designate is your health care agent or proxy. This document applies only to medical decisions and does not grant this person the rights to make financial transactions for you.
Choosing a Health Care Agent
This person doesn’t have to be a member of your family. You should feel comfortable with the person you choose and be able to discuss end-of-life decisions with him or her. Once you’ve made the decision, you should talk with that person to make sure he or she is willing to act as your agent for health care decisions. If that person agrees, you should let your family and physician know who you have selected. Some people also choose to select an alternate in case the first person can’t be reached in an emergency. Your selection can best be communicated with a written Advance Directive such as Directive to Physicians or Medical Power of Attorney.
Out-of-Hospital Do Not Resuscitate Order
Some people with a terminal illness decide that they do not want any resuscitation. With this legal document, which must also be signed by your physician, you communicate your decision to not be resuscitated when you are outside the hospital setting. This allows your wishes to be made known to emergency personnel who might respond to a call for help.
Treatments That May Require Advance Directives
Resuscitation
This is used to help you breathe and to restart your heart if it should stop beating. You can decide if and when you would want to be resuscitated by cardiopulmonary resuscitation (CPR) or by a device that uses an electric shock to start the heart. Some people with a terminal illness decide that they do not want any resuscitation.
Mechanical Ventilation
If you can’t breathe on your own, a machine can be used to breathe for you. You should consider if, when and for how long you would want to be on a ventilator.
Nutritional and Hydration Assistance
This is used to give your body nutrients and fluids, either intravenously or by using a tube that goes into the stomach. You should consider if, when, and for how long you would want to be fed in this manner. In Texas, artificial nutrition and hydration are considered life-sustaining treatments.
Hemodialysis
If your kidneys stop working, a dialysis machine can be used to remove waste from the blood and manage your fluid levels. In some cases, dialysis may be temporary, but it can also become permanent.
Palliative Care
Dealing with the pain and other symptoms that accompany a serious chronic or life-altering illness is difficult. Our hospital-wide Palliative Care Program provides a team approach to “palliative” care – care that focuses on relieving the pain and other symptoms of a serious illness – at the same time the patient is receiving curative treatment.
Palliative Care is available even when a person has been recently diagnosed with a serious or life-altering illness and is receiving treatment meant to cure the illness. It provides comprehensive services to help a person live more comfortably and productively with their chronic illness. To find out more information about United Regional’s Palliative Care Program and speak to a specialist, please call 940-764-4248.
Treatments for End-of-life Stage
If you have a terminal illness such as cancer, you should decide whether you want treatments such as antibiotics, resuscitation and ventilation. Would you want to receive only comfort or palliative care if you were terminally ill? If the treatment would delay your death, would you still want to receive it? You should know that you can still receive pain medication and comfort care, even if you choose not to be resuscitated if your heart or breathing stops.
Advance Directives Forms
Once you’ve completed the forms, you should give copies to your doctor, designated health care decision maker(s) and family members. You may also upload these documents directly into your MyChart account, where they will be available for your care team. You can revise or cancel your Advance Directive at any time regardless of your physical or mental condition. You’ll need to tell your doctor, attorney, agent and family members about any changes you make, as well as remove the old or upload new documents into your MyChart account.
To obtain a copy of the Advance Directive document by mail, contact 940-764-3360 or 940-764-8190.