Advance Directives l Advance Care Planning
What is an advance directive?
The term “advance directive” means any spoken or written instructions you give about the health care you want if a time comes when you are too ill to decide. Should you become too ill to make choices about your care, an advance directive can help others know what to do and give them peace of mind. Documenting your health care wishes spares loved ones the burden of making tough end of life decisions. By completing an advance directive, you can identify treatments you want/don’t want, state your wishes about donating your body, organs and/or tissues at death, outline your wishes about burial and funeral arrangements, and even state your wishes about resuscitation.
- Advance directive laws vary from state to state
- In Maine, anyone 18 years of age or older may use the MaineHealth advance directive form
- New Hampshire residents can find information and resources through the New Hampshire Foundation for Healthy Communities.
- If you are younger than 18, you may also be able to use an advance directive under certain limited conditions
- You have the right to change or cancel a health care advance directive at any time
- Your physician generally must follow the choices in your advance directive
- You can choose the time when your health care advance directive takes effect
- It could be effective immediately, or you may choose to have it only take effect when you become too sick to make decisions for yourself
- A health care advance directive does not take away your rights as a patient
- A health care advance directive does not apply to your money or property
More About Advance Care Planning
Advance care planning is not just about old age. At any age, a medical crisis could leave someone too ill to make his or her own health care decisions.
Your decisions about how to handle any of these situations may be different at age 40 than at age 85.
Or, they may be different if you have an incurable condition as opposed to being generally healthy.
Advance care planning is a process, and at any time you can change the instructions as you get older or if your viewpoint changes.
The first step to the planning process is to talk with your primary care provider. Requirements for completing an advance directive vary by state.
- Maine residents are encouraged to complete the MaineHealth advance directive form.
- If you are a New Hampshire resident, please call Memorial Hospital in North Conway at 603-356-5461, ext. 2194, for assistance. You also can find information and resources through the New Hampshire Foundation for Healthy Communities.
It is important to share your plan with those who may be involved with your care if you become very sick or injured and can no longer make decisions for yourself. This will help them know what you want for the end of your life. Consider giving a copy of your advance directive to:
Health care proxy or power of attorney
Partner or spouse
Primary care physician, family doctor or other medical care providers - for your medical record
Tell key family members and friends where you keep a copy. If you have to go to the hospital, give your care team a copy to include in your records. It’s a good idea to keep track of who receives a copy so you can provide them with an updated document if you change your advanced care plan.
Thinking about your end of life wishes can seem scary. One big step you can take in advance care planning is to talk to your loved ones about the kind of care you want for the end of your life. Sharing your thoughts and wishes lets others know about your preferences, making it easier for them to make decisions about your care.
You can create a special time to talk with loved ones or you could do it when you normally get together. You might set a goal to talk with your loved ones before a certain date, such as before your next birthday, after your next doctor’s appointment, or before your next vacation.
Important Topics to Discuss
Who will make choices for you?
- Who is your health care agent and back up agent?
- Which family and/or friends do you want involved in your care?
- Are there people you do not want making choices for you?
What gives your life meaning?
- If you were unable to know who you are or those around you, and there was little hope of recovery, would you want to be kept alive
- What outcomes would you consider worse than death?
What types of care would you want?
- Would you want treatment that prolongs your life even if a doctor believes you will not recover
- How would you like to be kept comfortable?
- Would you like pain medicine to keep you comfortable?
Under what situation, if any, would you want:
Cardiopulmonary resuscitation (CPR)
Help with breathing from a breathing machine (also known as a breathing tube or respirator)
Where would you like to live your last days?
Would you want to receive care in the hospital, a nursing home, or at home?
You might want to review your advance directive and talk to your loved ones again after every:
- Decade: When you start a new decade of life or every 10 years
- Death: If a close friend or loved one dies
- Divorce: If you go through a divorce or other major family change
- Diagnosis: If you are diagnosed with a new or serious health condition
- Decline: If your health is in decline due to an existing illness.
You should talk to your loved ones again any time you make a change to your advance directive.
Your health care proxy might be a family member, a friend, a lawyer or someone from your church or place of worship.
- Think about people you know who share your views and values about life and medical decisions
- You can decide how much authority your proxy has over your medical care—whether he or she is entitled to make a wide range of decisions or only a few specific ones
- It’s a good idea to name an alternate proxy as well (discuss this with those you choose before you name them officially)