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 Questions and Answers About Advance Directives
"What if my advance directive cannot be found?"
Written advance directives are often unavailable or can't be found
when important decisions need to be made. What happens to patients
who are at home when emergency treatment becomes necessary, but have
an advance directive in their hospital medical records?
Emergency medical teams will try cardiopulmonary resuscitation
(CPR) on all people found to be in cardiac arrest. This response
may not coincide with the wishes of people who are seriously ill.
In an effort to give patients control of this situation, many states
have ways to advise emergency medical technicians (EMTs) about your
directives. Some states issue bracelets, indicating a person's wish
not to be resuscitated if he or she is found unconscious by emergency
personnel. In other states, emergency medical technicians now look
for "do-not-resuscitate" (DNR) forms in prominent areas
in the home, such as on the refrigerator or next to a person's bed.
Similar to living wills, DNR forms allow individuals to document
preferences for care. Ask your doctor or call your local emergency
medical services organization to find out about local policies.
"I had a living will in Ohio and now I'm in Florida. Do
I need a new one?"
You have done a lot just thinking through the issues and writing
down your instructions. Probably, doing that will be enough to guide
your family and doctors. However, you should still rewrite your
advance directive if you move to another state. Some states have
said exactly which types of advance directives the law will recognize
as binding. State laws differ. Some states will recognize the laws
of the state in which the directive was executed. So, if you move
or cross state lines for health care, find out about this issue.
"What about planning for where to live when I am more disabled?"
Most life-threatening illnesses can cause worsening disability.
You are wise to make plans for how you will cope with disability.
Those plans might require fixing up a first floor room as a bedroom
or putting grab bars in the shower. They might require thinking
through whether a family member might move in, or whether to convert
a room to accommodate someone who could stay overnight. If you see
the possibility of a nursing home in your future, visit several
while you are still "in the driver's seat." You will learn
a great deal about which one will suit you best and how to live
well there. As you see more disability coming your way, it is a
good idea to talk with an experienced social worker or home care
nurse - someone who has "been there" with lots of other
people. Their suggestions will be very helpful in making sure that
you can live where you most want to be for as long as possible.
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