Advance Directives:
Why You Actually Have to
Talk to Your Aging Parents

Advance Directives are needed if there comes a time when your aging parents are unable to make health care decisions for themselves. Federal law states that each patient is in charge of their own medical care and medical decisions. 

Why do your parents need an Advance Directive?

Each patient must give consent (say "yes" or "no") before any medical procedure can take place. If your parents are ever incapacitated and unable to make their own medical choices, an Advanced Directive allows them to still be in control of their own care, but through the voice of someone else that they have already chosen. Advance care planning allows you to begin the conversations about their wishes and desires.

The next brief video explains this from the perspective of the doctor. Several medical doctors will help you understand exactly why it's important for people of all ages to have advance directives.

[Click on the arrow in the center to begin the video.]

One clarification of what you watched. There is a Durable Power of Attorney for Health Care that is discussed here, and it relates to medical decisions ONLY. There is also a Durable Power of Attorney for Finances that would be needed to handle anything related to money. Power of Attorneys for Health Care, and Finances are two separate processes, and one does NOT give authority for the other.

Something else to consider. The simple existence of a valid Advance Directive does not guarantee that it will be accurately followed by the health care professionals that are attending to your aging parents. Medical technology changes rapidly and most often requires human decision-making in ways that cannot be anticipated by any document.

While the Advance Directive naming a Health Care Power of Attorney permits someone to speak on behalf of your aging parents, only in depth conversations with them ahead of time, will actually empower a surrogate decision maker to make those choices with confidence.

When is an Advance Directive needed?

Don't be lulled into believing that this might only be triggered at the end of life. A sudden emergency or illness could temporarily render your parent incapacitated and unable to make their own health care choices. So an Advance Directive is essential, even if your parents are vigorous and in the best of health.

What, exactly, is an Advance Health Care Directive ?

This document usually consists of two primary parts. The document designates both a PERSON and a PROCESS. A chosen Person is legally permitted to make medical decisions on their behalf. This Health Care Power of Attorney (known by different names from state to state) carries the same authority as if he or she was the patient themself.

The Process spells out what actions an incapacitated patient would or would not want in the way of medical intervention at the end of life. These anticipated medical decisions are referred to in some states as a Living Will. So the Advanced Directives combine both the legal designation of a Durable Power of Attorney for Health Care (Person) and the features of a Living Will (Process).

The Basics of Advance Care Planning

What will you need to talk to your parents about? The list is not simple or easy. These talks will be about choices of medical care, treatments, procedures or other options at the end of life. Modern medical technology has so many possible procedures and machines that can be routinely prescribed at the end of life whether or not they HELP or they HARM your parents specific condition. Therefore, you will want to understand your parents' mindset and beliefs. You will need to know what is important to them and what they value as to their quality of life. The conversations should take place over time, and be shared with a variety of family members, and also, include your parents' doctors.

As legal documents, many people believe that they must be completed by a lawyer. That’s NOT the case. A properly signed document can be completed by anyone as long as it is witnessed. What matters as much as the papers, are THE TALKS. Thorough conversations with your parents, along with the signed documents, are the key. The entire process, known as Advance Care Planning is what is needed.

To move through this process your parents need:

  •   a document (see below);

  •   to choose a person for their medical power of attorney and ASK them if they would be willing to do it;

  •   several conversations with the person who is their durable power of attorney for health care - about values, beliefs and wishes;

  •   conversations with your parent's doctors -- about health conditions and treatment options, so they understand their choices;

  •   conversations with the extended family -- so everyone understands the process and their intentions;

  •   documents properly completed, witnessed and signed.

  •    Finally, the documents need to be distributed to the right people.

    Where do you get the medical power of attorney form?

    Each state has its own version. They vary in requirements and language. They vary in readability or "legalese". You get the documents from your doctor. You can get them at any local hospital. You can download them from your state government website.

    One national organization got a grant to translate every state's Advance Directives from "legalese" into language that is easy to understand. You can click here and download a form for an advance health care directive. that are valid for each state.

    Don't be put off if it seems long. It looks more intimidating than it needs to. Each state's version has a section at the beginning that explains the features and requirements of the document. And each version has a glossary defining terms at the end.

    You can download one for your state and just look through the document to get a feel for what’s required.

    If your parents live in a different state than you do, they will need to have the Advance Directive that is valid for their state. Go ahead and download one for their state AND one for your own state so you can get familiar with them and begin to see the differences.

    Emergency Information Crucial for Your Aging Parents. Are You the Health Proxy?

    You may be thinking that your aging parents are in good shape, or in good health and any thought of emergency information slips your mind. But they’re not immune from the accidents or sudden illness in the world. You do what you can to help them stay healthy and safe – but it’s also smart to be prepared.

    Medical Power of Attorney Q & A

    Questions & Answers on Being a Health Proxy, and the Medical Power of Attorney Form

    Advance Health Care Directive

    Why this process can solve many ethical dilemmas for your aging parents doctors.

    Ask Dale: Durable Medical Power of Attorney

    "My father has remarried. Who now is responsible for making medical decisions if he is not able to speak for himself?"

    End of Life Issues

    End of life issues and choices are the focus of a PBS documentary. Beginning these conversations with aging parents will help your family be prepared for the future with confidence and calm. Watch this clip...

    Making End of Life Decisions: A Real Life Example

    Making end of life decisions can't be easy. You'll need a framework of understanding to be able to talk to your aging parents and to get your own perspectives out of the way.

    Health Care Reform Act: Talk to Your Aging Parents About the Real Purpose of a Living Will

    The national health care reform act is in the news. ...Unfortunately there are rampant distortions and confusion about the part of the bill that would fund Advance Care Planning and your aging parents having conversations with their doctor about the end of life.

    Begin End of Life Planning Now with your Aging Parents. There’s more to it than you think…

    Talking about end of life planning is a challenge, at best. The biggest mistake you can make is to take your aging parents at their word when they say: “Don’t worry, we have everything planned.”

    Go to talk early talk often with aging parents Home Page

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