Making decisions about your future medical care can be difficult. But, planning ahead with advance directives allows you to guide your medical care according to your values and preferences if you become unable to make or communicate decisions yourself.

This article explores the three most common types of advance directives – living wills, durable medical powers of attorney, and physician orders for life-sustaining treatment (POLST). We’ll walk you through how these crucial records can guarantee that you receive the healthcare you desire.

What Are Advance Directives and Why Are They Important?

With advance directives, you can express your wishes for medical treatment ahead of time through formal legal documents. They give you a way to communicate your wishes about treatment so that providers and loved ones can honor those choices if you later lack the ability to decide or speak for yourself.

There are several reasons why advance directives can provide an important layer of protection:

  • You retain control over your care. Advance directives allow you to make your own decisions instead of leaving them up to interpretations of your wishes or values.
  • They provide clear guidance to your loved ones and medical team. This takes the difficult burden of guesswork off your family and doctors.
  • They align care with your values and priorities. Advance directives help ensure you get care focused on what matters most to you.
  • They are legally binding. Doctors and facilities are required to follow valid advance directives under Florida law.

Even though nobody enjoys considering getting gravely ill or hurt, making plans ahead of time lowers uncertainty and gives you peace of mind, knowing that your desires will be carried out.

The Living Will: Guiding Treatment When Terminally Ill

A living will is a written record of your preferences for medical care if you later have a terminal illness or are permanently unconscious. It gives specific instructions about life-sustaining treatments you would or would not want in those situations.

According to Florida law, a living will only take effect after two physicians certify in writing that you are unable to make or communicate medical decisions and are either terminally ill or permanently unconscious. At that point, the living will provide legally binding directions that guide your treatment.

A well-crafted living will should address whether you want interventions such as:

  • Cardiopulmonary resuscitation (CPR) to restart your heart and breathing if they stop
  • Mechanical ventilation is like a breathing machine. If you can’t breathe on your own
  • Artificial nutrition and hydration (tube feeding) if you can’t eat or drink
  • Dialysis if your kidneys fail
  • Comfort-focused treatments to reduce pain and suffering
  • Organ donation after death

You can be very specific about which treatments you want or don’t want. Your living will should also name someone to make any medical decisions not covered by your written instructions.

Living wills are powerful tools to control treatment in grave illness, but they do have some limitations:

  • They only take effect if you are terminally ill or permanently unconscious. For other situations impairing your ability to decide, a durable power of attorney is needed.
  • You must update the living will as your preferences change over time.
  • The instructions must be interpreted, leaving room for possible disagreement. Clear and detailed instructions reduce this risk.

Overall, living wills are invaluable for making your wishes known if facing the end of life. Discussing your preferences with your doctors and family also helps ensure shared understanding and comfort in following your instructions.

Durable Medical Power of Attorney for Health Care Choices

A durable medical power of attorney complements a living will by designating someone you trust to make health care decisions on your behalf if you are unable to do so yourself. This person called your health care agent or proxy, is given legal authority to interpret your preferences and make decisions in real-time as situations arise, in dialogue with your doctors.

There are two main advantages to naming a medical power of attorney:

  1. They can make decisions in situations a living will doesn’t cover. For example, if you’re in a coma after an accident but not terminally ill or permanently unconscious.
  2. They can apply your preferences in context. Your agent can interpret how you would weigh risks vs benefits for specific treatment options as circumstances unfold.

To create a medical power of attorney, Florida law requires naming someone 18 or older to serve as your health care agent. It’s critical to select someone you trust, who understands your values, and who will stand up for your wishes. Also, name alternative agents in case your first choice is unable or unwilling to serve.

Your power of attorney document should be detailed about any specific instructions you have for treatment options such as ventilation, feeding tubes, pain management, etc. Discuss these specifics thoroughly with the person(s) chosen to represent you so they can confidently convey your wishes.

Some key facts about durable medical powers of attorney:

  • They must be provided in writing to become activated if you’re incapacitated. Verbal instructions are not sufficient.
  • They only remain in effect while you are incapacitated – your agents cannot continue acting if you regain the capacity to decide for yourself.
  • You can revoke the appointment and/or instructions at any time as long as you have the capacity to do so.
  • Talk to an estate planning attorney if you have questions about ensuring it complies with Florida law.

Choosing someone to make such important medical decisions on your behalf is a big responsibility. But a well-crafted, durable power of attorney helps provide you with the peace of mind that your healthcare choices will align with your values and preferences even if you can’t speak for yourself.

POLST Forms: Medical Orders for Emergency Treatment

A Physician Orders for Life-Sustaining Treatment (POLST) form provides another option for advance care planning. It gives you a way to indicate specific medical orders regarding cardiopulmonary resuscitation (CPR) and other life-sustaining treatments that emergency medical personnel should follow.

A POLST is intended for someone with seriously advanced illness or frailty near the end of life. It translates your treatment preferences into immediately actionable medical orders. For instance, it can instruct EMTs whether or not to initiate CPR if your heart stops or employ a breathing tube and ventilator if you stop breathing.

To complete a POLST form, you’ll have a discussion about treatment options with your healthcare provider based on your current health status. You decide which options you want, and then your provider signs the form, making your choices actionable as medical orders. These orders must be followed in any medical emergency.

Key aspects of POLST forms:

  • They are medical orders, while standard advance directives guide treatment but don’t provide orders.
  • POLST forms require a healthcare provider’s signature to be valid.
  • Emergency personnel must comply with the orders in a valid POLST in an emergency.
  • The orders only apply to emergency treatment – your medical power of attorney still guides other care decisions.
  • POLST forms are not yet available in every state, so availability varies.

For those with advanced serious illness, a POLST can provide an extra layer of assurance your treatment wishes will be honored in a medical crisis. Discussing options with your doctor and creating a POLST provides actionable orders emergency responders must follow to give you the type of care you want.

How Advance Directives Help You Guide Your Care

Dealing with serious illness is challenging on many levels. By making your voice heard through advance directives, you can help guide care in alignment with your values, priorities, and preferences if you are unable to make your own decisions.

We hope this overview gives you a helpful understanding of the main types of advance directives. Planning ahead with living wills, durable medical powers of attorney, and POLST forms enables you to exert more control so you can face the future with greater confidence and peace of mind.

The attorneys at Elder Needs Law in Florida have extensive experience advising clients on creating customized advance directives. Please don’t hesitate to contact their office if you need guidance on putting these important documents into place.