Preparing Advance Directives

• Before you prepare your advance directives

• You can prepare your own advance directives

• Have your advance directives witnessed

• You can change your advance directives

• After you have completed your documents

Before you prepare your advance directives: 

• Get information on the types of life-sustaining treatments that are available.
• Decide what types of treatment you would want or would not want.
• Discuss with your doctor what your treatments are expected to accomplish and what the risks of these treatments are.
• Share your end-of-life wishes and preferences with your loved ones.

You can prepare your own advance directives.

• You do not need a lawyer to prepare advance directives.
• Make sure you prepare your advance directive to accurately reflect your decisions.
• Use your state specific advance directives.
• If you choose not to use the state specific advance directives, make sure you review any generic forms to ensure that language in one form does not conflict with language in another form.
• In most states, you can include special requests in your advance directives such as hospice care or wishes about organ donation, cremation or burial.
• You also should be sure to make your physician and loved ones aware of your specific requests so appropriate referrals and arrangements can be made.
• Ask someone else to look over the documents for you to be sure that you have filled them out correctly.
• Read all of the instructions carefully to ensure that you have included all of the necessary information and that your documents are witnessed properly.

Remember this – Completing an advance directive is just the first part of guaranteeing your end-of-life care wishes.  After completing your advance directive you need to talk to your family, your doctor (s) and friends about your wishes.

Have your advance directives WITNESSED.

Every state has some type of witnessing requirement.  Most require two adult witnesses; some also require a notary.  Some states give you the option of having two witnesses or a notary alone as a witness.  The purpose of witnessing is to confirm that you really are the person who signed the document, you were not forced to sign it, and you appeared to understand what you were doing.  The witnesses do not need to know the content of the document.  Read the instructions and the documents carefully to ensure that the witnessing is done properly.

All states require that your witnesses be adults.  Beyond that, the requirements vary from state to state.  Generally, a person you appoint as your agent or alternate agent cannot be a witness.  In some states your witnesses cannot be any relatives by blood or marriage, or anyone who would benefit from your estate.  Some states prohibit your doctor and employees of a healthcare institution in which you are a patient from acting as witnesses.  Again, read the instructions carefully to see who can and cannot be a witness.

You can change your advance directives.

An advance directive remains in effect until you revoke it.  If you complete a new advance directive, it invalidates the previous one.  For this reason you should review your advance directives periodically to ensure that they still reflect your wishes.  If you want to change anything in an advance directive once you have completed it, you should complete a new document.

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After you have completed your documents:

• Your New York health care proxy and New York living will are important legal documents.  Keep the original signed documents in a secure but accessible place.  Do not put the original documents in a safe deposit box or any other security box that would keep others from having access to them.
   

• Give photocopies of the signed originals to your agent and alternate agent, doctor(s), family, close friends, clergy and anyone else who might become involved in your health care.  If you enter a nursing home or hospital, have photocopies of your documents placed in your medical records.
   

• Be sure to talk to your agent and alternate, doctor(s), clergy, family and friends about your wishes concerning medical treatment.  Discuss your wishes with them often, particularly if your medical condition changes.
   

• If you want to make changes to your documents after they have been signed and witnessed, you must complete new documents.
   

• Remember, you can always revoke one or both of your New York documents.
   

• Be aware that your New York documents will not be effective in the event of a medical emergency.  Ambulance personnel are required to provide cardiopulmonary resuscitation (CPR) unless they are given a separate order that states otherwise.  These orders, commonly called non-hospital do-not-resuscitate orders are designed for people whose poor health gives them little chance of benefiting from CPR.  These orders must be signed by your physician and instruct ambulance personnel not to attempt CPR if your heart or breathing should stop.  If you would like to receive a non-hospital do-not-resuscitate form, speak to your physician.

If you would like more information about this topic, please call United Hospice of Rockland, Inc. at 845-634-4974.  We can provide you with a copy of the Caring Connections booklet, “Cardiopulmonary Resuscitation, Do-Not-Resuscitate Orders and End-of-Life Decisions.”