There may come a time in your life when you are unable to make decisions for yourself. A sudden accident, serious stroke, dementia or coma could leave you incapable of understanding your health care options, making living arrangements or simply taking care of day-to-day personal matters. What happens then? Who would make these decisions for you?
An advance directive—also referred to as an advance medical directive, advance healthcare directive or living Will—could help you keep some control in worst case medical scenarios or towards the end of your life.
What an advance directive does
An advance directive is a document that can do a few things:
- Record your preferences and instructions for your future medical care
- Outline your wishes for living arrangements, personal matters or end of life care
- Appoint someone to make these decision on your behalf (sometimes referred to as power of attorney)
The contents of an advance directive are only followed if you are unable to make these types of decisions for yourself.
An advance directive is valuable for medical staff, but could also provide your family with some peace of mind. Next of kin may need to make tough decisions when a loved one develops a serious illness, is involved in an accident or loses mental capacity as they age. Since people are often unwilling to discuss these types of situations, families may be unsure of their relative’s wishes. Advance directives can help remove some of the burden and confusion from family members during this time.
Writing an advance directive
In New Zealand, almost any adult can provide instructions for their future medical care. So long as you are capable of understanding and making these decisions when you write your advance directive, your doctors should be able to follow the instructions, if they are one day needed.
An advance directive doesn’t need to be filled with complicated medical instructions. It might provide only general wishes. Typically, a healthcare directive may cover things like:
- Why you are making an advance care plan
- Any cultural or religious beliefs which might impact medical decisions, or rituals you’d like performed at the end of your life
- Who will make decisions for you, if you are unable to do so yourself (power of attorney)
- How much you’d like to know about your health or medical treatments (such as an estimate for how much time “you have left,” or allowing doctors to do what they think is best rather than involving you or your power of attorney in every decision)
- Preferences for some specific situations, such as stopping all medications and treatments that don’t add to your comfort, or refusing certain resuscitation attempts
Advance directives don’t have to be written down (you could simply have a conversation with your family or GP), but it may make sense to do so. This could help remove any confusion or doubt that might arise. You don’t need a solicitor to draft an advance directive, and it can be witnessed by as many people over the age of 18 as you choose, though two is usually a good number.
You can also update or draft a new advance healthcare directive whenever you like. This way, if you change your mind or wish to take into account new information, your instructions could be as up-to-date as possible.
Can my medical instructions go in my Will?
If you’re already thinking about writing or updating your last Will and testament, you may think to include medical wishes and power of attorney decisions in this document. It might seem reasonable to have a single document rather than two, but advance directives and Wills really achieve different goals.
An advance directive deals with situations that may occur whilst you’re still alive. Wills provide instructions for handling your property and other assets after you’ve passed away. In the case of a Will, it may not be located or read until after a person’s funeral.
For many people, it may make sense to have both an advance directive and a last Will. This could help cover any instructions you might want followed before and after you pass away.
Creating a plan
Writing an advance directive or providing end-of-life care instructions could be an important step in planning for your future care, and beyond. Consider talking to your doctor, healthcare team and family about your wishes. That way, when the time comes, they can help you live your life with the dignity and respect that everyone should have.
Thinking about other parts of your end-of-life plan? Download our free Funeral Wishes Guide today!
Ministry of Health, Advance Care Planning: A guide for the New Zealand health care workforce
New Zealand Medical Association, Advance Directive
Disclaimer: The information provided in this article is of general nature, and does not take into account your personal situation. You should consider whether the information is appropriate to your needs or seek professional advice, where necessary.