• It’s not just for older people. It is important for young people too, as they could be kept alive for decades in a condition they would not want.
• Advance healthcare directives aren’t synonymous with “don’t treat.” Some people choose only to have their pain controlled when death is near; others want all possible treatments. It is your opportunity to let your family and physician know of your wishes.
• You do not give up control of your healthcare decisions. Only when you are unable to communicate will the advance healthcare directive be followed.
• You do not need a lawyer to make an advance healthcare directive.
• You do not need a specific form. You can write your wishes down yourself. It has to include your signature and date and the signatures of two qualified witnesses.
• It does not have to be notarized. Witnessed by two people is sufficient.
• Your wishes do not have to be in writing, but it is very helpful if they are.
• You do not have to have a surrogate decision-maker, but it is recommended. A surrogate decision-maker is someone you have chosen to make decisions for you if you are unable to make them for yourself.

• Doctors and hospitals are obligated to follow your advance healthcare directive. In order to follow it, your physician and hospital must be aware of it. It is up to you to ensure that everyone who might need a copy of your advance healthcare directive has one.
• If emergency medical services are called to any location outside an acute care hospital (such as your home or healthcare facility), they are required to resuscitate and stabilize patients until safely in a hospital. If you do not wish to have cardiopulmonary resuscitation (CPR), you must have a special “pre-hospital do-not-resuscitate” form. This form, which has to be signed by your doctor, protects you from having CPR.
• Carry identification that includes where to easily obtain a copy of your advance healthcare directive.
• Keep a ready copy of your advance healthcare directive at home along with a current list of medications and health conditions.
• If you live in a skilled nursing facility or nursing home, the long-term care ombudsman, or patient advocate, is required to witness your signature on your advance healthcare directive.

• Start with your doctor. Discuss the types of medical problems you may face based on your health and history. Your doctor can help you understand the treatment choices.
• Think about your goals for medical treatment. It is impossible to plan for every medical event, but you can make your preferences for medical treatment clear.
• Identify the quality of life you find acceptable.
• Pick someone you trust to be your surrogate decision-maker. This should be someone who would be able to make tough decisions, who would speak up in a crisis situation, who understands your desires and who would speak for you when you are unable to speak for yourself.
• If you choose more than 1 decision-maker, designate who will be 1st and who will be 2nd. You should have at least 1 alternate person, in case the 1st person is unavailable.
• You can indicate if there is someone whom you do not want to make your decisions for you.
• If there are medical treatments you do not want under any circumstances, make that very clear. You have the right to refuse any medical treatment or surgery.

• If you do not agree with the language in a pre-made form, change the language. Sign a form only after you are certain that it truly reflects your specific wishes.
• You can write your wishes in your own words, but you have to be certain they can be clearly understood by others. You may want to go over this with your doctor to be certain medical care providers can understand your wishes. As long as your wishes comply with the law, they will be followed.
• Discuss your wishes with your surrogate decision-maker, your family and your doctor.
• Sign the document in the presence of someone who is not your decision-maker; is not related to you by blood, marriage or adoption; will not benefit from your estate; or is not your healthcare provider. An unrelated friend, neighbor or minister make ideal witnesses.
• Be certain your wishes and instructions are clearly understood by all.
• If you have a local hospital, give a copy of your advance healthcare directive for their files.
• Give a copy to your physician and surrogate decision-maker.

Absolutely!

• In writing, tell your surrogate and your physician.
• Destroy all the copies of the old one, and create a new one.
• Be sure a give a copy of the new one to your physician, surrogate and hospital.

• The advance healthcare directive with the most recent date is the legal one, and this is the one that will be followed.
• If you do not have time to put your changes in writing, tell your doctor, family and friends who are present exactly what you want to happen. Wishes that are made in person will be followed in place of the ones made earlier in writing.