
Have you thought about the type of care and medical treatment you may want should you ever become unable to make decisions or speak for yourself?
It’s hard for most of us to imagine this scenario, especially when we are young and healthy. However, you never know when you may experience a medical emergency. A car accident or sudden illness can leave you incapacitated and in need of serious medical care.
Advance care planning is making decisions about the healthcare you would want to receive if you’re facing a medical crisis. These are your decisions to make based on your personal values, preferences, and discussions with your loved ones. Advance care planning helps you prepare for the unexpected while you are well and able to make difficult decisions for yourself.
Questions? Please call Mary Washington Healthcare Patient Relations Department 540.741.3955.
Advance care planning includes:
82% of people say it’s important to put their wishes in writing, but only 23% have done it.
The Virginia Health Care Decisions Act allows you to make two types of decisions about your end-of life healthcare in an Advance Directive.
Please remember to bring your or your loved one’s Advance Directive to the hospital.
The Patient Self-Determination Act was passed by Congress in 1990. Under this act, healthcare institutions are required to inform their patients and their communities about their rights to make decisions concerning their medical care. Accepting care, refusing care, and making advance directives about their care are included under these rights.
An Advance Directive consists of legal documents that put your medical wishes in writing and allows you to choose someone you trust to make healthcare decisions for you. These documents offer peace of mind that, should the unthinkable happen, you’ve made your wishes known.
Preparing an Advance Directive is also an important gift to your loved ones. They will rest easier knowing they are making medical decisions based on what you do or do not want.
Virginia Advance Directive Form for Healthcare with Sections for Medical and End-of-Life Care (pdf)
Virginia Advance Directive Form for Mental Health Care (pdf)
A Living Will documents your wishes for medical care should you ever be unable to speak for yourself due to a serious illness or accident.
Examples of medical treatments addressed in a Living Will:
A Living Will is different from a Last Will & Testament, which directs how you wish to distribute your assets and property upon your death.
A Medical Power of Attorney gives a trusted person the legal power to make decisions on your behalf if you cannot.
Depending on where you live, the person you choose to make decisions on your behalf may be called one of the following:
Choosing a person to act as your healthcare agent is important. Even if you have other legal documents regarding your care, not all situations can be anticipated and some situations will require someone to make a judgment about your likely care wishes. You should choose a person who meets the following criteria:
The person you name may be a spouse, other family member, friend or member of a faith community. You may also choose one or more alternates in case the person you chose is unable to fulfill the role.
Virginia Advance Directive Form to Appoint a Healthcare Agent (pdf)
You don't need to have an advance directive or living will to have do not resuscitate (DNR) and do not intubate (DNI) orders. To establish DNR or DNI orders, tell your doctor about your preferences. He or she will write the orders and put them in your medical record.
Even if you already have a living will that includes your preferences regarding resuscitation and intubation, it is still a good idea to establish DNR or DNI orders each time you are admitted to a new hospital or health care facility.
Frequently Asked Questions provided by the Virginia Bar Association:
An Advance Directive allows you to state your choices for healthcare or to name someone to make those choices for you, if you become unable to make decisions about your medical treatment. It enables you to say "yes" to treatment you want, or "no" to treatment you do not want.
You may execute a power of attorney for healthcare, a written healthcare directive, or both. Of the two kinds of Advance Directives, a power of attorney for healthcare is broader. A written healthcare directive is helpful in stating your wishes, but it may not be possible to anticipate all possible medical situations for which your written healthcare directive might apply. The best way to protect your interests, however, is to execute both.
No. Advance directives may address any type of care in situations in which you cannot make decisions for yourself. For example, an advance directive may address psychiatric (mental health) issues, chronic disease issues, and wishes about admissions to certain types of healthcare facilities.
You should always share your healthcare wishes with your loved ones and your doctors. However, you may only create an Oral Advance Directive if you have a terminal condition and tell your wishes directly to your doctor. Also, putting your wishes in writing reduces confusion about your wishes since people often forget or misunderstand what was said orally.
You should still execute an Advance Directive to describe the important values and beliefs you have. You can also indicate your religious beliefs. Often, these types of statements will help others make appropriate healthcare choices for you when you cannot make them yourself.
You can, and should, put your wishes in your own words. Just describe as best you can what medical care you do and do not want.
Yes. No one knows what the future might bring. For example, you might need someone to make medical decisions for you in the event that you suffer a sudden injury or illness (such as a car accident). It is better to choose this person in advance and tell him or her about your healthcare wishes. If you do not choose someone in advance, the law will assign a decision maker who must guess about your wishes.
You may appoint any adult (18 years or older). This person needs to be accessible, but he/she does not need to live in Virginia. When you choose your agent, make sure that you have chosen someone who will be able to make potentially difficult decisions about your care, is willing to serve as your agent, and is aware of your wishes. You should also choose an alternate in case your first choice is unavailable (for example, your first choice may not be found or may not be willing to be your agent).
You really should pick just one person as your agent. Picking more than one person can result in a conflict, delay decision-making, or result in an inability to make any decision at all. You can include your other children by letting them know your choices. You may also require your one agent to talk with your other children prior to making any decisions.
No. Your agent only gets to make healthcare decisions for you if your doctor and another doctor or licensed clinical psychologist examine you and determine you cannot make decisions for yourself. Furthermore, as soon as you can speak for yourself again, decision-making authority returns to you.
You may cancel or modify your Advance Directive at any time, but it is important that you tell others that you have canceled or changed your Advance Directive.
It means that your doctor has determined that you are likely to die soon or that you are in a persistent vegetative state, which is when you have no awareness of your surroundings and your doctors have determined you will not recover.
It means using machines, medicines, and other artificial means to help you breathe, eat, get fluids in your body, have a heartbeat, and otherwise stay alive when your body cannot do these things on its own. Life-prolonging treatment will not help you recover. It does not include drugs to keep you comfortable.
Yes. Your Advance Directive will enable your physicians and family to know that this is your wish.
Yes. No matter what you choose about life-prolonging treatment, you will be treated for pain and kept comfortable.
No. Your physicians and nurses may not discriminate against you based on your healthcare choices. You will get whatever care is appropriate, but you will not get any treatment that you have stated you do not want.
Yes, your husband/wife can be your witness. Other blood relatives can also be witnesses as long as they are adults.
Yes, but to avoid the chance of conflict, it is better to have someone who is not your agent (or your alternate agent) be a witness.
No.
Yes.
Probably not. It is better to have a separate healthcare power of attorney document. If you are in doubt, consult a lawyer or ask at a hospital.
No. This is one of the major reasons to create an Advance Directive.
It should be. Just as Virginia honors Advance Directives properly executed in other states, most states have similar rules to honor out-of-state Advance Directives. Nevertheless, if you spend a considerable amount of time in another state, you may want to have an Advance Directive executed for that state as well. You may also want to register your Advance Directive with an online registry, such as US Living Will Registry.
Just as important as creating an Advance Directive is making sure that other people know that you have it and know where it is located. Specifically, you should:
Additionally, you should keep a copy of your Advance Directive in a safe place where it can be found easily. Do not keep your only copy in a lock box or safe.
No. Free forms are linked at the top of this page.
A lawyer is not required to draft a valid Advance Directive. There are free forms available at the links above, but a lawyer may help you if you have questions or complex healthcare needs. The free forms are also only models. You can use them or numerous other forms or no form at all. Just be sure that whatever you use includes: (1) your healthcare wishes, (2) your signature, and (3) the signatures of two adult witnesses.
A DNR is a doctor's order saying that you will not get CPR, drugs, or electric shock to restart your heart or breathing if your heart stops or you stop breathing. A Durable Do Not Resuscitate Order (DDNR) is a special DNR order that your doctor can provide you so that EMS, fire, and rescue and any healthcare provider will know your wishes about resuscitation. Note: copies of DDNR forms are now valid in Virginia, and DDNR forms may be downloaded (to bring to your physician) at the Office of Emergency Medical Services website.
Yes. Your advance directive may provide organ donation and other anatomical gift wishes.
Have you thought about the type of care and medical treatment you might want should you ever become unable to make decisions or speak for yourself?
It’s hard for most of us to imagine this scenario. However, you never know when you may experience a medical emergency. Advance Care Planning is making decisions about the healthcare you would want to receive if you’re facing a medical crisis. These are your decisions to make based on your personal values, preferences, and discussions with your loved ones. Advance Care Planning helps you prepare for the unexpected while you are well and able to make difficult decisions for yourself.
April 16th is National Health Care Decisions Day. Mary Washington Healthcare, along with other community, state, and national organizations, is leading an effort to raise awareness of the importance of advance healthcare decision‐making. National Healthcare Decisions Day encourages all adults in the U.S. to consider their healthcare wishes. The day hopes to inspire, educate and empower the public and providers about the importance of advance care planning.
Mary Washington Healthcare is here to help. If you need assistance in completing an Advance Directive or have questions about Advance Care Planning please call Mary Washington Healthcare Patient Relations Department 540.741.3955