Planning in Advance – Make your wishes known

PUTTING IT IN WRITING

In the event you are unable to speak for yourself, an Advance Directive communicates how medical care choices should be made and who should make them.

Advance Directives are for everyone – plan ahead and make your wishes known.

Advance Directive forms are free – see below for links to download.

Questions: Please talk to your primary care provider.

WHAT IS AN ADVANCE DIRECTIVE?

Because of illness or injury people are sometimes unable to talk to a doctor and decide about treatment for themselves. You may wish to plan in advance to make sure that your wishes about treatment will be followed should you become unable to decide for yourself. In New York State, appointing someone you can trust to decide about treatment if you become unable to decide for yourself is the best way to protect your treatment wishes and concerns.

There are five types of Advance Directives in New York State:

  • A Health Care Proxy lets you appoint a healthcare agent -- that is, someone you trust to make and stand by health care decisions for you, based on YOUR wishes if you are unable to make decisions for yourself.
  • A Living Will is a document that allows you to leave written instructions that explain your health care wishes, especially about end-of-life care. You cannot use a Living Will to name a health care agent; you must use a Health Care Proxy.
  • A Living Will together with a Health Care Proxy lets you state your health care wishes and name a health care agent.
  • A Do Not Resuscitate Order (DNR) only lets you express your wish to do without cardiopulmonary resuscitation (CPR) - that is, emergency treatment to restart your heart and lungs if your heartbeat or breathing stops.
  • Medical Orders for Life-Sustaining Treatment (MOLST) are one way of documenting a patient's treatment preferences concerning life-sustaining treatment.

Making your Advance Directive known:

  • Make several copies of the completed and signed forms
  • Keep the original forms in a safe place that you can get to easily
  • Give copies of the forms to your health care agent, if you’ve appointed one, your doctor or other healthcare provider, your care partner and anyone else you choose to involve in your healthcare
  • Consider carrying a wallet card that says you have an Advance Directive and where the forms may be found

Adirondack Health ADVANCE DIRECTIVES POLICY

Adirondack Health has adopted an Advance Directives policy to ensure that medical treatment decisions reflect the wishes of our patients and comply with current ethical and clinical guidelines and applicable state and federal laws.  If you are hospitalized, you or your representative will be asked if you’ve completed an Advance Directive. If your answer is yes, a copy of your Advance Directive is placed in your Medical Record. If you currently don’t have an Advance Directive in place but would like to complete one, please talk to your primary care provider or the Social Worker, if you’re in the hospital.

You may revoke (take back or change) your Advance Directive at any time by informing your doctor or provider, showing an intention to revoke it to any health care professional or by creating a new directive.

ADVANCE DIRECTIVE TREATMENT CHOICES

Advance Directives can limit life-prolonging medical treatment when there is little or no chance of recovery. Medical treatment at the end of life usually falls into three main categories - life supporting, life sustaining and life enhancing.  Life support uses CPR and machines to keep your heart and lungs going when they can no longer work on their own.  Life sustaining care involves treatment or machines to prolong your life when your condition can’t be reversed or cured.  Life enhancing or comfort care keeps you comfortable until your death occurs naturally. No artificial measures are taken to prolong your life.

FREQUENTLY ASKED QUESTIONS

Do I need legal assistance to appoint a health care agent?

No. Attorneys need not be involved. All you need to do is complete a health care proxy form as directed and sign it along with two other witnesses. The witnesses must be over the age of 18. The agent may not be one of the witnesses.

Who can be my health care agent?

Anyone at least 18 years of age can be a health care agent. He or she needs to be someone you trust and they should be familiar with your values, thoughts about healthcare choices and moral and religious beliefs. The most important thing is that you talk with your health care agent about your health care wishes, and make sure you give your agent a copy of the proxy form.

What decisions can my health care agent make?

Unless you limit your health care agent’s authority, your agent will be able to make any treatment decision that you could have made if you were able to decide for yourself. Your agent can agree that you should receive treatment, choose among different treatments, and decide that treatments should not be provided, in accord with your wishes and interests. If your health care agent is not aware of your wishes about artificial nutrition and hydration (nourishment and water provided by feeding tubes), they will not be able to make decisions about these measures. Artificial nutrition and hydration are used in many circumstances and are often used to continue the life of patients who are in a permanent coma.

May I use the health care proxy form to express my wishes about organ and/or tissue donation?

Yes. Use the optional organ and/or tissue donation section on the Health Care Proxy form. You may specify that your organs and/or tissues be used for transplantation, research, or educational purposes. Any limitation(s) associated with your wishes should be noted in this section of the proxy.

Can my health care agent make decisions for me about organ and/or tissue donation?

No. The power of a health care agent to make health care decisions on your behalf ends upon your death. Noting your wishes on your Health Care Proxy form allows you to clearly state your wishes about organ and tissue donation.

Can I have more than one health care agent?

You can have one agent and an alternate agent. Your alternate agent will represent you if your agent is not available.

Can I change my health care agent?

Yes, you may change your health care agent. If you make this change, you’ll need to fill out a new Health Care Proxy identifying your new agent. It’s important that you give a copy of the new form to your primary care physician or provider and to any facility that would have your Health Care Proxy on file.

Health Care Proxy

Fill out a Health Care Proxy to appoint someone as your health care agent in the event you are unable to make your own health care decisions.

Download the Health Care Proxy Form

https://www.health.ny.gov/publications/1430.pdf

MOLST

Read more about the MOLST and download a copy.

https://www.health.ny.gov/professionals/patients/patient_rights/molst/

Family Health Care Decision Act

New York State law allows for the use of a surrogate list for those without a health care proxy in place and who are unable to make their own health care decisions.

Learn more at https://www.health.ny.gov/publications/1503/