Advance Directives Should Be Filed Before You Need Them


Angela N. Mitchell

Have you designated someone to make medical decisions and sign paperwork for you should you become unable to make decisions for yourself? If not, experts advise you to get your paperwork in order now.

Angela N. Mitchell, LHRM, RHIT, ACA, is the health information management services manager at Lakeland Surgical & Diagnostic Center. She says that it is important for everyone to have advance directives, such as a Living Will or a Health Care Surrogate Designation on file so that your wishes are known in case of a life-threatening illness or injury. It is especially important for those with a diagnosis of Alzheimer’s or another disease that could limit decision-making power.

A Living Will, for instance, will document life-prolonging measures that you may or may not want.  They can be very specific, such as stating you do not wish to be placed on a ventilator or that you do not want other measures used to keep you alive but in a vegetative state.  Terminally ill patients also may want to consider a do-not-resuscitate (DNR) order. A DNR order ensures procedures will not be performed that will prolong the natural process of dying. “That is a decision I never want my kids to have to make for me,” Mitchell says.

“A diagnosis like Alzheimer’s is long-term,” Mitchell says. “You really should designate a durable medical power of attorney and document your wishes as soon as possible to ensure they are known and followed.” Appointing a durable power of attorney grants authority to a family member or other designee to act on your behalf when you are unable to make medical, financial or legal decisions.

When there is no clear power of attorney or advanced directive on file, medical professionals must follow the “order of priority,” Mitchell says. The order of priority is as follows: the patient’s spouse, adult child or majority of adult children, parent of the patient, adult siblings, adult relative, close friend or clinical social worker.

“The order of priority can get tricky,” she says.  Siblings may not always agree on what is best for a parent, and they could end up in court fighting over who has decision-making power.

“The most important thing for Alzheimer’s patients, or any patient, is to have advance directives on file before you are incapacitated,” Mitchell says.

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