• Advance Directives - Palliative Care

    Lahey Clinic's Palliative Care Service patients often have to make decisions about advance care goals, and in some cases, end-of-life care before more serious medical problems or conditions occur. Advance directives are legal instructions about the types of medical care you would want to receive in the event of a terminal illness, coma or brain damage. The directions may be oral or written, and various states have different rules, but the most common advance directives are CPR directives, durable power of attorney for health care (DPOAHC), a living will and organ donation.

    Advance directives are important because without them, family members may be unaware of, or may misinterpret, your wishes regarding your care. It is recommended that you write down what you want to prevent confusion in managing your care and ensure your concerns are respected. While there are many different regulations and forms that must be dealt with when making these decisions, the overviews below can give you a general idea of why and how these advance directives are important.

    • CPR directives allow you the right to refuse resuscitation if you are incapacitated. Health care facilities will attempt to revive a patient unless there are specific orders to the contrary.
    • A durable power of attorney for health care (DPOAHC) is a legal document that allows you to select someone to make medical decisions for you. This representative can be helpful when your medical team and loved ones have difficulty deciding how to treat you. This person should be someone trusted to follow your instructions exactly as written in your DPOAHC.
    • A living will describes the type of care you do or do not want when you are still alive but nearing death. Living wills can help your doctors and loved ones know more about what you want when it comes to your health care. These directives are a record of the care you would want but may be unable to choose for yourself due to a terminal illness or injury.
    • Organ donation may become an issue if you are classified as legally brain dead. In that situation, you may or may not want your organs and tissues donated for use in transplants. Various states have different rules or forms regarding organ donor declarations. Make sure to include your wishes in your living will and inform your health care agent whether or not you want to be an organ donor.

    Perhaps the most important thing to realize is that these types of decisions should be made now. Discuss what you want with your family and doctors, write it down, and make it legal. It might not always be easy to talk about, but planning your future health care can help spare you and your loved ones further difficulties in the future.