Please Note: Because so many of our clients ask us about advance directives, Comfort Keepers has prepared the following summary descriptions.  The choice of whether to use any kind of advance directive is entirely up to you. This information is not intended as legal advice and it may not apply in your specific situation.  Please consult your attorney if you wish to have an advance directive.

​Advance Directive

An advance directive is a witnessed, written (and in some states oral) statement voluntarily executed by a person who is mentally competent. It may appoint an agent who will render health care decisions on behalf of the client and/or may indicate the type of treatment or having the treatment withheld in the event the client is unable to make such decisions when treatment is necessary. Almost all state laws provide that an advance directive can be revoked. Written revocations generally must meet minimal requirements, for example, they may need to be signed, dated, and communicated to the attending physician. Some states, however, allow an advance directive to be changed or revoked orally.

Living Will

A living will is a written client directive expressing, in advance, the client’s wishes regarding the use or withholding of extraordinary life-sustaining measures in the event he or she is incapacitated or terminally ill. Living wills are statutorily created in each state, and the particular requirements for a valid instrument vary from state to state. Often, living will legislation is embodied in Natural Death Acts. Models for living wills are incorporating more details to allow a client/patient to clearly state preferences with respect to CPR, artificial nutrition and hydration, kidney dialysis, mechanical or artificial respiration, blood transfusions, surgery, and antibiotics.

 
Durable Power of Attorney

The power of attorney is a written document that authorizes an individual, as an agent, to perform certain acts on behalf of and according to the written directives of the person executing the document, from which the agent obtains authority. The vast majority of states provide for durable powers of attorney specifically for health care decisions. Under this type of legislation, the state authorizes the appointment of an individual who is specifically empowered to make personal health care-related decisions for another person in the event that he or she becomes incapacitated. Many state legislatures have provided model forms in their statutes, which include specific choices for the conditions under which life-sustaining treatment may be withdrawn. Unlike a living will, which is generally limited to situations where the client is either terminally ill or permanently unconscious, the power of attorney can apply to a wider range of situations in which the client is unable to communicate a choice regarding a health care decision. In addition, the power of attorney allows the client’s agent to make any decision regarding an incapacitated client’s/patient’s health care and is not limited to specific life-sustaining measures.

Do Not Resuscitate Order

A Do Not Resuscitate (DNR) order is a written order from a doctor that resuscitation should not be attempted if a person suffers cardiac or respiratory arrest.  Such an order may be instituted on the basis of an advance directive from a person or from someone entitled to make healthcare decisions on their behalf.

For the DNR to be valid there may be rules such as the use of a special form, and/or additional signatures of a doctor or witnesses.  Generally, physicians can provide the proper form for their state.