Like most people, you probably take the ability to make decisions for yourself for. What would happen, however, if you were unable to make decisions for yourself one day because of your own incapacity? Chances are good you would prefer to make as many of those decisions ahead of time as possible to ensure that they are honored. One way to do that is to execute an advance directive. In this blog, we’ll explain who will make healthcare decisions for you if you can’t make them.
Are Your Protected If You Become Incapacitated?
When you think about the possibility of your own incapacity, you probably focus on one day developing Alzheimer’s or another age-related condition during your senior years. Although Alzheimer’s disease and other age-related conditions certainly can cause incapacity, the possibility of becoming incapacity is not limited to the elderly. A catastrophic car accident, a debilitating illness, or a serious workplace injury could render you incapacitated tomorrow. In fact, just over one in four of today’s 20-year-olds will become disabled before they retire. Whether incapacity strikes when you are 25 or 85, the questions will apply, including:
- Who would have the legal authority to make health care related decisions for you?
- Does that person know what your wishes would be regarding medical care, specifically end of life treatment?
- How can you ensure that your wishes regarding end of life treatment will be honored?
Executing an advance directive now allows you to provide the answer to these questions in the event you are unable to express your wishes for any reason at a later date.
California Health Care Decision Documents
The State of California recognizes various documents. They include:
- Advance Health Care Directive (AHCD) – this is the primary document. It lets you name someone (your “Agent”) to make decisions about your health care. Unless otherwise written in your AHCD, it becomes effective when your primary doctor determines that you lack the ability to understand the nature and consequences of your health care decisions or the ability to make and communicate your, health care decisions. If you want your Agent to make health care decisions for you now, even though you are still capable of making health care decisions, you can include this instruction in your ACHD designation. You can also name an alternate Agent. Unless you limit your Agent’s authority, your Agent may make all health care decisions for you, including:
- Consenting or refusing consent to any care, treatment, service, or procedure to maintain, diagnose, or otherwise affect a physical or mental condition.
- Selecting or discharging health care providers and institutions.
- Approving or disapproving diagnostic tests, surgical procedures, and programs of medication.
- Directing the provision, withholding, or withdrawal of artificial nutrition and hydration and all other forms of health care, including cardiopulmonary resuscitation.
- Making anatomical gifts, authorize an autopsy, and direct disposition of remains.
- You can also make your wishes known through what was previously done through the so-called “Living Will” discussed below.
- Individual Instructions – this is an older form of California’s “Living Will.” It allows you to give specific instructions about any aspect of your health care, such as your wishes with regard to the provision, withholding, or withdrawal of treatment to keep you alive, as well as the provision of pain relief. It is now incorporated in California’s AHCD.
- Do Not Resuscitate (DNR) – this older form applies prior to admission to a hospital and instructs EMS personnel to forgo resuscitation attempts in the event of your cardiopulmonary arrest. It has been largely replaced by the POLST form discussed immediately below.
- Physicians Orders for Life Sustaining Treatment (POLST) — this form, used for patients with a serious illness or whose life expectancy is a year or less, outlines a plan of care reflecting the patient’s wishes concerning medical treatment and interventions at life’s end. The POLST form effectively turns your treatment preferences into actionable medical orders by allowing you to make very clear and specific choices regarding your desire to receive life-sustaining treatment versus your desire to be given comfort measures only.
Please download our FREE estate planning checklist. If you have additional questions or concerns about planning for the possibility of your incapacity, contact us at the Northern California Center for Estate Planning & Elder Lawby calling (916)-437-3500 or by filling out our online contact form.