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Advance Directives 101

Completing an advance directive can be an emotional experience and many people have lots of questions. There is no denying that end of life can be quite stressful for all. Preparation through advance- care planning can offer some peace of mind and control over an unpredictable situation. Taking the time to consider your preferences at end of life establishes how you want to live and what is most important to you. Let’s take some time to unpack the process.

What exactly is an advance directive?

An advance directive is a document that serves two main functions:

  1. It allows you to declare what healthcare you wish to receive, or not receive, if you are unable to speak for yourself.
  2. It allows you to choose someone you trust to make healthcare decisions on your behalf if you are unable to speak for yourself.

An advance directive is also called a living will. It’s different from a last will and testament, which deals with property and goes into effect after you die.

What is covered in an advance directive?

Directives include thoughtful questions that can help you define your values at end of life. Advance Directives provide an opportunity to declare your wishes related to medical treatments and procedures, including:

  • Cardiopulmonary Resuscitation (CPR)
  • Artificial Nutrition and Hydration
  • Life Support Treatments
  • Comfort Care
  • Organ and Tissue Donation
  • Psychiatric Treatment and Medications

Directives can also include prompts for personal preferences at end of life, such as ways that you want to be cared for through touch, what music you would like to hear, if you would like to be read to and if so, which books, poems, or hymns. These personal preferences include cultural and spiritual practices, personal messages for loved ones, people you wish to see or not see, and really anything else that is important to you.

Who should I name as my healthcare agent?

Choose someone you trust who knows your wishes and will advocate for you if you are unable to speak for yourself. It is important to name an alternate healthcare agent as a backup in case your primary agent is not available. Other names for healthcare agent include: healthcare proxy, healthcare surrogate, and durable power of attorney.

When should I complete an advance directive?

The time is now! There is a misconception that advance care planning is just for older adults or those who are ill. Advance directives are for all adults, even healthy, active adults, at any age. We certainly do not expect or plan to be in a situation where we are so injured or sick that we are unable to communicate our healthcare decisions. Having this document in place provides guidance and direction for your healthcare team and loved ones when the unforeseen happens. Keep in mind that you can update, change or revoke any part of your entire advance directive at any time.

How do I find advance directive documents?

SEARHC has recently adopted a directive that you can access here. Each state has its own version of an advance directive; you can find Alaska’s directive here. There are many other options available worth exploring but be sure that the directive you choose meets legal requirements for Alaska. Five Wishes is a popular option that is valid in Alaska. Alaska Law Help offers helpful video and written tutorials for completing a directive.

How does my advance directive become legal?

An advance directive is made legal in two ways. It can be notarized by a notary public or it can be witnessed by two people who are personally known to you. There are several criteria witnesses must meet:

  1. Witnesses cannot be your healthcare agent.
  2. Witnesses must be over 18 years old.
  3. Witnesses cannot be a healthcare provider who takes care of you.
  4. Witnesses cannot be an employee of your healthcare provider or health institution or facility.
  5. In addition, at least one witness cannot be related to you by blood, marriage or adoption and is not entitled to your money, property, permits or a portion of your estate.

What next?

Once you have completed your directive, provide a copy to your primary and alternate healthcare agent, your loved ones, friends and your physician. Place the document somewhere easily accessible in case of an emergency. If you are interested in support with this process or have questions, please contact Erin Matthes at ematthes@searhc.org or (907) 966-8720.

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The SEARHC Crisis Help Line, 1.877.294.0074, is available 24 hours a day, seven days a week to residents of Southeast Alaska.