Advance directives: Plan for the unexpected

Imagine you were in a serious car accident and were left unable to speak for yourself. Who would speak for you? Who would make needed medical decisions while you were unable to communicate?

It’s a scenario none of us expects to be in, yet it happens every day. Preparing for a moment like this is easier than you might think.

Fill out an advance directive

An advance directive is a document that clears up confusion when a person is unable to communicate because of an injury or illness and decisions must be made for them. Advance directives allow you to:

• Name a person who can make health care decisions for you.
• Express your wishes for medical treatment options.
• Prepare final thoughts and feelings should your illness or injury be life-threatening.
• Request special ceremonies or traditions you would like carried out.
• Communicate wishes for post-death care of your body.

“Advance directives are a great way to help the provider understand who the important people are in the patient’s family to be in touch with,” said Dr. Thomas Gabert, a Marshfield Clinic internal medicine physician.

Protecting your wishes

Everyone 18 and older should have an advance directive.

“When we don’t know whom to turn to, we often lose minutes if not hours trying to understand who’s important to the patient and how to best respect the patient’s wishes,” Gabert said.

The default approach for patients who cannot speak for themselves is to do everything possible for them treatment-wise. Some patients wish to be made comfortable rather than extensively treated, but without someone to speak for them, they cannot express that wish.

“The best way for patients to make sure their wishes and values are respected is to take the time, when there is not a crisis, to complete the advance directive paperwork,” Gabert said.

It starts with a conversation

Completing an advance directive is the end of a process that begins as a conversation with loved ones. You should talk with loved ones about questions like:

• What makes a good day for me and whom would I spend it with?
• Whom do I want to speak for me if I can’t speak for myself?
• Have past experiences shaped my feelings about the treatment I would want in that situation?
• How do I define quality of life?

These questions help you outline your values and fill out your advance directive.

“The process of completing the paperwork gets families talking around the kitchen table,” Gabert said. “Many families come out of this process enriched by having that shared conversation.”

An advance directive is a document that should change as your life changes. For instance, if your health care decision maker moves away, you may need to elect a new decision maker.

If you’re interested in filling out an advance directive, call Marshfield Clinic Community Resources at 715-389-5008.