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Advanced Directives

 

 

As we all know, life is highly unpredictable: life can, and often does, change in a heartbeat. Advanced directives are a critical piece of planning for life's unforeseen events, whether you are young or old, healthy or infirm. Essentially, advanced directives express your wishes in the event that you are no longer able to do so yourself. There are numerous types of advanced directives, including financial living wills, health care living wills, and physician-ordered directives, such as a DNR, a POLST, or a Comfort One. In addition, it is advisable to designate a durable power of attorney for health care, or a health care proxy, who will make sure your health care wishes are carried out. Hospice social workers are available to speak to you about any of the following advanced directives:

 

Living Will for Health Care

 

A living will expresses your health care wishes for you in the event that you can no longer do so yourself. Living wills may be written by attorneys, or they are available free of charge on the internet. In Montana we are fortunate to have My Choices, which is a living will document that may be submitted to the Montana End-of-Life Registry. Click on the following link to access a My Choices document: https://app.mt.gov/registry/.

 

Montana Provider Orders for Life-Sustaining Treatment (POLST)

 

Technically a POLST is not an advanced directive; it is a physician's order. The POLST is a medical form that indicates what types of life-sustaining treatments you do or do not want if you become seriously ill. The POLST must be signed by a physician. A POLST is recommended in addition to a living will. A POLST can be transferred from one setting to another. For more information, visit http://polst.mt.gov.

 

Comfort One

 

The Comfort One is the predecessor of the POLST. It also must be signed by a physician, but unlike the POLST the Comfort One only applies to cardiopulmonary resuscitation (CPR). Essentially the Comfort One tells paramedics and other medical professionals that you do not want CPR or other heroic measures taken to save your life. A Comfort One is similar to a DNR (do not resuscitate), except a Comfort One is intended for a patient living at home rather than the hospital. Currently Montana providers are required to honor both the POLST and the Comfort One; beginning in January of 2011 the Comfort One will no longer be valid in Montana.

 

Do Not Resuscitate (DNR)

 

A DNR is intended to prevent cardiopulmonary resuscitation for patients who have chosen not to prolong their life. Like the POLST, the DNR is a physician's order, and generally applies in medical settings such as the hospital.

 

Durable Power of Attorney for Health Care (DPOA)

 

A DPOA is a trusted person whom you assign to help make health care decisions in the event you are unable. There is a difference between a DPOA for financial decisions and a DPOA for health care. Commonly, patients choose two separate people for each of these roles. You may choose more than one DPOA for health care. Your DPOA is supposed to honor your wishes, and to assure that your living will is honored. In Montana, the My Choices document also designates a DPOA for health care. Go to: https://app.mt.gov/registry/.