By Karen Love for the Silver City End of Life Options Coalition
What if one of the most important legal documents you can have doesn’t require a lot of time or expertise to complete and doesn’t even require a lawyer? That important document is called an Advance Directive (AD), and it makes your healthcare preferences clear in the event you are unable to communicate your medical treatment wishes yourself.
Although several previous articles in this column have touched on the topic, this article will focus solely on the AD: what it entails, what you need to know to complete yours, and where to get the form.
An Advance Directive usually includes a “living will” (enumerating what kinds of treatment you do or do not want to sustain life in the event of a medical crisis) and a medical power of attorney (designating who will speak for you regarding healthcare matters, if you cannot). The time to complete the AD is before a medical crisis occurs!
Recently, my 91-year-old mother experienced a medical crisis that ultimately led to her death. For many years, she had an AD (in which she had designated me as her medical spokesperson), had discussed her wishes with me, and had provided copies of the AD to me and her physician as well as keeping a copy in her purse. Even in the midst of a very stressful situation, I was comforted greatly in knowing exactly what my mother did and did not want with regard to end of life treatments.
Given the importance and simplicity of completing an AD, we would hope most people have one; however, in both the hospital where I took my mother and subsequently at a hospice facility, the nurses and doctors noted that our case was an exception – often, a family is unsure of their loved one’s wishes, and that uncertainty can lead to family members arguing about what to do. In addition, family members often experience guilt and second-guessing of their decisions in the aftermath of such a stressful event.
Fortunately, creating an AD poses no obstacles. Most states have their own forms, and New Mexico is no exception. You can find the New Mexico form on-line by going to the University of New Mexico School of Medicine’s website: here.
Near the top of that webpage, when you click the “sample form” link, you will see the AD form, entitled “Optional Advance Health-Care Directive.” The explanation at the top of the form includes the following: “You have the right to give instructions about your own health care. You also have the right to name someone else to make health-care decisions for you. This form lets you do either or both of these things.”
Part 1 of the form “lets you name another individual as agent to make health-care decisions for you if you become incapable of making your own decisions.” Part 2 of the form “lets you give specific instructions about any aspect of your health care. Choices are provided for you to express your wishes regarding life-sustaining treatment, including the provision of artificial nutrition and hydration, as well as the provision of pain relief.” In addition, the form has a section that allows you to designate a physician to have primary responsibility for your health care.
After completing the desired parts of the form, you sign and date it. It is recommended, but not required in the state of New Mexico, that you also have the form notarized, with two other individuals to sign as witnesses. Should you be out of state when the need arises, there are a few states that require the AD to be notarized and may not honor it otherwise.
Other organizations also provide forms. Aging with Dignity has a form called "Five Wishes" (agingwithdignity.org/forms/5wishes.pdf) that they state satisfies the requirements of New Mexico law. According to the University of New Mexico’s School of Medicine website, “some benefits of "Five Wishes" are that it is simple and easy to complete, written in several languages including English and Spanish, and it raises many issues that can be considered.”
In addition to keeping a copy of your AD with you (in a purse or wallet and in the glove compartment of your car) and giving a copy to your designated healthcare power of attorney, you can provide a copy to your physician and may be able to have a copy placed on file at your local hospital.
Besides the important components already described, an AD can also include documents such as a dementia provision and a sectarian healthcare directive. These additional forms are available through the Compassion and Choices website (look under the “Plan Your Care” tab here). Note that New Mexico also has a form for advanced mental health care directives; a link to that form can be found through the University of New Mexico site here.
In addition, if you have a serious or life-limiting illness, specific treatment orders can be written by a physician (New Mexico Medical Orders for Scope of Treatment, or MOST). New Mexico “MOST” is part of a national approach to end of life planning based on conversations between patients, their loved ones, and healthcare professionals designed to ensure that seriously ill or frail patients can choose the treatments they want or do not want and that their wishes are documented and honored. More information is available on the website here.
Although planning for the end of life might seem overwhelming, it’s not! With just a few minutes of time and some thought about your wishes, you can have the peace of mind for yourself and your loved ones brought about by having your end of life affairs, including an Advance Directive, in order.
For more information on end of life options see the following resources:
To contact the Silver City End of Life Options Coalition or leave comments: firstname.lastname@example.org