LARGE PRINT - MULTISTATE Health Care Advance Directive
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If you are too ill to think or speak for yourself, who do you want to speak for you? Have you told them? Have you shared your wishes for care?
A Health Care Advance Directive is a person’s written instructions in case he or she (the “Declarant”) is unable to make health care decisions in the future. This is a “combination directive,” which includes both the appointment of a health care proxy to make decisions (like a “Durable Power of Attorney for Health Care”) and care instructions that the Declarant’s proxy and health care providers must follow when acting on behalf of the Declarant (like a “Living Will” or “Declaration”).
Attorney and award-winning author Jo Kline Cebuhar (www.JoKlineCebuhar.com) has been writing and speaking about Advance Care Planning issues for over a decade. She is the author of award-winning books on end-of-life issues and the meaning of legacy, including her 2006 Last things first, just in case – The practical guide to Living Wills and Durable Powers of Attorney for Health Care. In 2015, she authored a revised and updated edition of that book, The practical guide to Health Care Advance Directives (2015 Edition), a 2015 USA Best Books Awards Winner.
Through her research and teaching, it became obvious to Jo that advance directive forms provided by government and private agencies have not kept up with modern medical conditions or contemporary treatment options. To answer that need, she has created this Multistate Health Care Advance Directive.
What makes this Health Care Advance Directive different is that it:
* Clearly explains the essential legal and medical concepts of Advance Care Planning.
* Is easy for the Declarant to complete and for proxies and physicians to honor.
* Provides for the appointment of a proxy, with instructions for the proxy's role as advocate.
* Includes advanced dementia as a "triggering event."
* Distinguishes between tubal feeding and assisted oral feeding (spoon feeding).
* Has instructions for providing nutrition and hydration apart from the use of or withholding of other life prolonging measures.
* Respects patient autonomy and individual beliefs by permitting a Declarant to personalize the form.
The Multistate Health Care Advance Directive is available in both regular font and LARGE-PRINT versions.
Some states mandate statutory forms or language. This form should not be executed in those states without obtaining legal counsel concerning its applicability. You can find information on restrictive jurisdictions at your state’s government web sites or at www.Advance-Directives.net.
The offering of this legal document is not a substitute for getting competent legal and medical counsel from qualified professionals to address any questions the Declarant may have about how this directive applies to his or her specific health care situation and whether it provides an accurate record of the Declarant’s care instructions. You are not required to have an attorney’s assistance in completing this directive. However, if you need complementary estate planning and incapacity documents (such as a Last Will & Testament or a Power of Attorney for Financial Matters) or if you want assistance understanding and preparing to complete this document, you should seek legal counsel.