The different names of health care directives or similar legal medical documents can create a lot of confusion for the client and their families. Let’s look at the 3 types of health care documents.
Health Care Directive: Type One
- Advanced Directive
- Patient Advocate Designation
- Durable Power of Attorney for Health Care
These are all the same documents. They accomplish 2 things. First, the designate someone to speak on your behalf if you ever become incapacitated. Second, they state your wishes regarding life support.
In more than 20 years in practice, I can’t recall ever having a client ask me for an Advanced Directive that didn’t make it clear that they did not want life support if there was no chance of recovery.
Health Care Directive: Type Two
- Living Will
This is perhaps the one name for a document that causes more confusion than any other. All a living will is a directive regarding life support. It does only half of what an advanced directive should do. It is not a will. It is not a Living Trust. I try to avoid both the use and title of this document in my practice. It is not unusual for me to field a call from a family who just lost a parent. I will ask whether there was a will or trust. The child may say yes – when they are really talking about nothing more than a Living Will – which accomplishes nothing once a person has died.
Health Care Directive: Type Three
- DNR or Do Not Resuscitate Order
- No Code Order
These likewise can cause confusion. Many people will ask me to prepare a DNR when they are still young and healthy. They are confusing it with an advanced directive.
A DNR is a short statement, usually only a couple of sentences long, that says you refuse all treatment except pain management. It is typical signed when a patient begins hospice. It is an essential document that instructs caregivers not to resuscitate you when your health fails.
“Every person over 18 years of age should sign a Type One advanced directive, give a copy to their family, their primary care physician – and anyone concerned about their care. ”
Every person over 18 years of age should sign a Type One advanced directive, give a copy to their family, their primary care physician – and anyone concerned about their care. They should carry a wallet card directing medical personal how to obtain a full copy of this important document. We can assist anyone in getting one prepared, and if they have limited means – can direct them to a free form offered by the State of Michigan – while not perfect, is so much better than not having one.
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