Advance directives: Everyone needs one

March 17, 2016 Providence Guest Blogger

By JoAnn Hoven, Providence staff

Becky Brinda had known about advance directives for a long time; her husband had completed one after he was diagnosed with lung cancer. But when Becky herself was diagnosed with a serious disease—chronic obstructive pulmonary disease, or COPD—she just hadn’t gotten around to putting her health care wishes down on paper, to be followed if she were incapacitated and unable to communicate.

An emergency, but no advance directive

That changed in August, when a severe thunderstorm smacked Missoula.  Becky hadn’t been feeling well when the power went out, cutting off her electric oxygen generator. By the time she and a visiting neighbor found and activated the portable oxygen system, Becky had passed out.

In the emergency room at Providence St. Patrick Hospital, physicians put Becky on a BiPAP machine to make sure she had a steady stream of oxygen. During Becky’s three days in the hospital, someone said to her: “We almost lost you.”

Advice on what to do next

“I hadn’t realized that things could get bad that quickly,” Becky says.

After Becky returned home, she met with Linda Bierbach, RN, a Providence palliative care coordinator, to discuss an advance directive.

Bierbach answered Becky’s questions, helped her understand unfamiliar terms and went over medical procedures that a person may or may not want in an emergency or at the end of life.

“The best way to be prepared is to have an advance care planning conversation with your loved ones and complete an advance directive,” says Bierbach. “Doctors and the medical care team want to provide care for you consistent with your values and beliefs. When you have a completed advance directive and have shared the plan with your loved ones, they can speak for you when you can’t speak for yourself.”

Peace of mind

“It was hard to do — no one wants to think about the end of their life—but I feel better now,” says Becky. “I know that if I’m ever in a situation like that again, unable to say what I want and don’t want, my wishes will be known.”

Here are some questions and answers to help you start thinking about your own advance directive and what you want it to include.

Q: Who needs an advance directive?
Everyone 18 and older should have an advance directive. Serious illness or injury can occur at any time and prevent you from communicating your wishes for medical care.

Q: What documents are in an advance directive?
They include a health care directive, often called a “living will,” and a durable power of attorney for health care. The living will spells out what kind of medical care you would want.  A durable power of attorney gives a person of your choosing the power to act on your behalf.

Q: When is an advance directive used?
An advance directive is used only when you are unable to make medical decisions for yourself. The person you appoint to act on your behalf would use the health care directive to make sure your medical wishes are honored and make related decisions.

Q: Can I change my advance directive?
As long as you are capable of making decisions, you can change your advance directive at any time.

Q: Do I have to have a lawyer to complete an advance directive?
No. The law does not require that you have an attorney. The choice is yours.

Q: Why is it important to have an advance directive?
You make choices on a daily basis—choices about where you want to live, your career, your life. Another important choice is the kind of medical care you want. An advance directive can help make sure you get that care.

Q: Where do I start?
Advance-care planning involves discussions with your family, loved ones and doctor about:

  • Your health care goals
  • What kind of care and treatment you want
  • Your personal beliefs and values and how they relate to your health care wishes
  • Who you want to make decisions on your behalf if you can’t make them yourself

Q: Do I need to talk to my physician?
Yes, it is important to talk to your physician to make sure your plan is clear and complete. Make sure your provider has a copy of your written form.

Q: Who can help me with questions about advance care planning?
Your health care provider can answer questions and help you find a specialist to help with forms and other information. If you don’t have a provider, find a Providence provider near you.

You also can learn more about advance directives and find resources for preparing one at the Providence Institute for Human Caring.

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