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Tricky Names for Health Care Directives

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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