Advance Directives

We don’t often like to think about the end of our lives or the possibility of being so ill that we’re incapacitated — but being prepared can make a stressful situation less stressful for you and your loved ones. That’s where advance directives come in.

What are advance directives?

We use the term “advance directives” to refer to several documents that will help the people caring for you understand your wishes. Advance directive documents allow you to give instructions to your health care provider if you can’t speak for yourself due to injury or illness. Although Colorado law provides for written instructions only, it is the intent of Colorado Canyons Hospital & Medical Center (CCHMC) to honor a patient’s verbal instruction, which should be put into written form as soon as possible. The following items can be used to provide these instructions:

 

Living Will

This document allows you to state your wishes about medical care in the event that you’re terminally ill or in a persistent vegetative state and can no longer make your own decisions. The Living Will becomes effective immediately once it is signed. It’s put into action once two doctors admit that a person is terminally ill and will die with or without the use of life-sustaining procedures, or that the person is in a persistent vegetative state. You don’t have to get this form witnessed or notarized.

Colorado CPR Directive

An advance medical directive intended for outpatient use made by a person or his or her authorized agent, in advance of a situation in which he or she may suffer a respiratory or cardiac arrest. This document states the person’s wishes regarding the use of CPR. The form issued by the Colorado Department of Health can be used an is available in English and Spanish.

Medical Durable Power of Attorney

This document lets you empower someone to make decisions about your medical care, including life support, if you can no longer speak for yourself. It’s a written declaration signed by the patient designating a person to make health care decision for the patient in the event the patient loses decision-making capacity.

Medical Orders for Scope of Treatment, or MOST

A one-page, two-sided document that consolidates and summarizes patient preferences for key life-sustaining treatments including CPR, general scope of treatment, antibiotics, artificial nutrition, and hydration. This form requires the signature of a physician or a non-physician provider. This form is intended to replace the CPR Directive Form.

How do advance directives work?

Once your advance directive is on file, CCHMC physicians and staff will honor and comply with it as long as the necessary physician orders are in place. CCHMC shall inform all patients/patient representatives of any limitations if the hospital cannot honor an advance directive on the basis of conscience. A statement of limitation shall include, at a minimum:

  1. Clarification of any difference between hospital-wide conscience objectives and those that may be raised by physicians;
  2. Identification of state legal authority permitting such an objection;
  3. Description of medical conditions or procedures affected by conscience objection.

Who should have an advance directive?

It’s worth filling out an advance directive if you are a “competent person” age 18 or older. (A “competent person” is defined as any person 18 years of age or older or any emancipated minor, as long as he or she is of sound mind). After 18, if you’re admitted as an inpatient to any of our facilities, you’ll be asked about advance directives — the staff will want to know if you have one, or if you’d like to place your wishes in your medical file.

Advance directives might sound like they’re just for older people, but these documents are actually even more important for younger people. The stakes are higher: If you fall seriously ill or have an accident, you may be kept alive for decades in a condition you wouldn’t otherwise want. Advance directives can help your family and health care team understand what you want.

You aren’t required to complete advance directives, and you’ll be treated regardless of whether you have them or not. But we would encourage you to discuss your wishes with your family members and your physician so everyone is on the same page when the time comes.

What if I want to change my advance directives?

It’s easy. You can cancel or revoke your advance directives by issuing a new living will and medical durable power of attorney for health care, or you can write to the hospital or institution that holds it and state that it should be cancelled or revoked.

Don’t all advance directives mean “don’t treat”?

Not at all. Most people use advance directives to avoid being kept alive against their wishes when death is near, but that doesn’t mean all advance directives translate to “don’t treat.” Your advance directive could state that you’d like all possible, available treatments during your illness, for example. It’s really about expressing your personal values and wishes.

What happens if I don’t have advance directives?

If you don’t have one, you won’t be part of your health care decisions. By law, decision-making power will go to proxy- or substitute-decision makers — usually, family members in order of kinship.

How can I put my own advance directives in place?

Complete Living Will and Medical Durable Power of Attorney for Healthcare forms, then:

  • Give a copy to the person you appointed as your decision-maker, also known as your medical power of attorney or agent.
  • Give a copy to your family members and loved ones. Take the time to discuss your choices, values, and preferences.
  • Give a copy to each of your physicians. You can take a copy with you on your next office visit. If you have a specialist that you don’t visit often, mail one to the office address with a note asking for the document to be added to your medical record.
  • If admitted to CCHMC, the admitting nurse will discuss whether or not an advance directive exists, and if so, the patient or significant other will be asked to provide a copy for inclusion in the patient’s medical record.

Where can I learn more?

For additional information or assistance in completing your advance directives, visit the American Hospital Association website.