Wednesday, December 15, 2010

Health Care Directive or Health Care Power of Attorney

What is a Health Care Directive?
A health care directive is a written document that informs other of your wishes about your health care. It allows you to name a person (“agent”) to decide for you if you are unable to decide. It also allows you to name an agent if you want someone else to decide for you. You must be at least 18 years old to make a health care directive.

Why Have a Health Care Directive?
A health care directive is important if your attending physician determines you can’t communicate your health care choices (because of physical or mental incapacity). It is also important if you wish to have someone else make your health care decisions. In some circumstances, your directive may state that you want someone other than an attending physician to decide when you cannot make your own decisions.

Must I Have a Health Care Directive? What Happens if I Don’t Have One?
You don’t have to have a health care directive. But, writing one helps to make sure your wishes are followed. You will still receive medical treatment if you don’t have a written directive. Health care providers will listen to what people close to you say about your treatment preferences, but the best way to be sure your wishes are followed is to have a health care directive.

What if I am competent to make my own health care decisions?
Unless you stipulate otherwise, your health care agent makes decisions for you only if you are no longer able to make health care decisions for yourself.

If I have filled out a Living Will, do I also need a DPAHC?
It is a good idea to complete a DPAHC in addition to a Living Will, or to combine them in one document. A Living Will usually allows you to state your desires regarding life-sustaining treatment in the event that you become terminally ill or permanently unconscious. Most states include these types of instructions in their DPAHC forms. By selecting a health care agent through a DPAHC, you ensure that someone you trust will oversee decisions and implement your wishes regarding any treatment, not just life-sustaining treatment.

Who should I choose as a health care agent?
You should choose a person whom you trust, such as a spouse, partner, family member or close friend. The person you choose should know your personal values and beliefs. If possible, you will want to choose someone who lives in your area in case he or she is called upon to direct your treatment for an extended period of time. You will want to discuss your health care wishes with your agent and be sure he or she is willing to act on your behalf. Many states will not allow your health care provider or anyone working in a health facility to be a health care agent.

Can I choose an alternate health care agent?
Yes. You should choose at least one alternate person to act as your health care agent in case your first choice is unable or unwilling to make health care decisions for you.

How do I execute a DPAHC?
You must be at least 18 years of age and mentally competent to execute a valid DPAHC. You must sign your DPAHC form. Most states will also require qualified adult witnesses and/or a notary public to sign the DPAHC, acknowledging that you are competent and acting under your own volition. No attorney is required. If you are in a nursing home, other witnessing requirements may apply.

I Prepared My Directive in Another State. Is It Still Good?
Health care directives prepared in other states are legal if they meet the requirements of the other state’s laws or the California’s requirements. But requests for assisted suicide will not be followed.

What If My Health Care Provider Refuses to Follow My Health Care Directive?
Your health care provider generally will follow your health care directive, or any instructions from your agent, as long as the health care follows reasonable medical practice. But, you or your agent cannot request treatment that will not help you or which the provider cannot provide. If the provider cannot follow your agent’s directions about life-sustaining treatment, the provider must inform the agent. The provider must also document the notice in your medical record. The provider must allow the agency to arrange to transfer you to another provider who will follow the agent’s directions.

What If I’ve Already Prepared a Health Care Document? Is It Still Good?
California law provided for several other types of directives, including living wills, durable health care powers of attorney and mental health declarations. The law changed so people can use one form for all their health care instructions. Older forms are still legal if they followed the law in effect when written. They are also legal if they meet the requirements of the new law (described above). You may want to review any existing documents to make sure they say what you want and meet all requirements.

What Should I Do With My Health Care Directive After I Have Signed It?
You should inform others of your health care directive and give people copies of it. You may wish to inform family members, your health care agent or agents, and your health care providers that you have a health care directive. You should give them a copy. It’s a good idea to review and update your directive as your needs change. Keep it in a safe place where it is easily found.

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