How Advance Directives Work in Real Life

If you go to the trouble to create an Advance Directive, is there a chance that the document will be overlooked or even ignored by time-pressed healthcare professionals?

It’s possible, according to Bayli Fields, an attorney at Kimbrough Law, a Life Care Planning Law Firm in Athens, Georgia.

In the state of Georgia, an Advance Directive combines what was formerly known as a Healthcare Power of Attorney with the document once known as a Living Will. “In an Advance Directive, you nominate people to make healthcare decisions for you if you can’t make them for yourself,” says Fields.

When counseling clients, Fields makes it clear that an Advance Directive is what she calls a “people plan.” “You’re expressing your preferences so that the people you trust to make decisions on your behalf will know what you want,” she says. “Since you can't cover every possible scenario on an Advance Directive form, you’re empowering your Healthcare Agent to use their best judgement in any given situation.”

In theory, a Healthcare Agent doesn’t have to do what the principal, or the person writing the Advance Directive, requests. To get an order for treatment that’s legally enforceable, you need a Physician’s Order for Life-Sustaining Treatment. “That’s a decision plan, not a people plan,” Fields notes.

Why create an Advance Directive? First, it will help alleviate guilt that can be associated with certain decisions that family members may have to make. “With an Advance Directive, no one needs to wonder what Mom or Dad would have wanted, which makes things much easier when the time comes,” advises Fields.

In most states, if a person doesn’t have an Advance Directive, his or her children can make decisions about care. But without an Advance Directive, decision-makers may disagree about what should be done. “The Advance Directive is important because it specifies which child you want to make decisions, and in what order,” says Fields. “The Advance Directive helps you avoid the free-for-all that can happen if you have more than one child.”

What’s the best way to make sure that your wishes are followed? Documenting them on your state’s Advance Directive form is a good first step, advises Fields. In most states, Advance Directive forms are available from attorneys, hospitals, and other healthcare providers. Fields advises against downloading forms from the internet. “Online forms are risky because you may not get the right statutory version,” she notes.

Having the form where it’s needed, when it’s needed is another challenge. Clients of Life Care Planning Law Firms are counseled to prepare for these possibilities. “I've had older clients put it on a magnet on their refrigerator, and they grab it when they're picked up by an ambulance,” notes Fields. 

What else can you do? One option is to purchase a subscription to an online service that will store your Advance Directive in the cloud and give you a card to carry in your wallet. Another option is to scan the document or take a picture and save the file on your phone or in a cloud-based service like Dropbox. “When you’re out of town, take a digital version with you and make sure that multiple people have it,” adds Fields. “In fact, when you’re sharing your travel itinerary with loved ones, make sure to include your Advance Directive. You—and they—won’t regret it.”