The importance of advanced directives

The importance of advanced directives

Julie Scott, DNP
Julie Scott, DNP

What is advanced care planning?

Advanced care planning is something every person should consider for themselves, even if they are not currently faced with a life-threatening illness. Advanced care planning allows you to make healthcare decisions for yourself, even if you’re in a condition in which you’re unable to speak for yourself due to illness or emergency. Making these decisions and having them documented can be helpful for loved ones who would otherwise have to make those decisions for you.

Some of the decisions that are determined in advanced care planning can include the following:

  • The use of CPR (cardiopulmonary resuscitation)
  • Feeding tube placement or other artificial nutrition and hydration
  • Use of a breathing machine (ventilator)
  • Organ donation

There can be multiple documents that are involved in advanced care planning.

Living will

The living will is a written document that states your personal decisions on healthcare interventions, to be followed when you are in a condition where you cannot speak for yourself. Each state may have different rules on what needs to be present on what makes the document legally binding. Your healthcare provider can give you a blank living will for you to fill out. This document will state your wishes on healthcare interventions for things such as CPR, feeding tubes, and dialysis. Contact a lawyer for any specific legal questions you may have about the document.

Durable Power of Attorney (DPOA)

A DPOA for healthcare is a legal document in which you appoint someone to make medical decisions on your behalf. This appointed person would then make medical decisions for you if you were in a state where you could not make decisions for yourself. Having a conversation with your DPOA about your wishes is a good idea.

Do Not Resuscitate (DNR)

A DNR is an order in which medical staff is instructed NOT to perform life-saving measures such as CPR or breathing machines when going into cardiac or respiratory arrest. This is most important in the hospital setting and should be documented in the chart by the healthcare provider.

Another type of DNR, called an outside-the-hospital DNR, is a document that can be completed and is available in the home. In the instance of a cardiac or respiratory arrest at home, the outside-the-hospital DNR is shown to any emergency responders and would allow them not to do CPR. Each state may have different forms and signatures required for this.

Advanced care planning is a vital but often overlooked aspect of healthcare. These discussions are crucial to have while one still has the ability to speak for themselves. If you or a loved one is considering making a living will or DPOA, please contact a lawyer or social worker at your cancer center for help in completing the necessary documentation.

Having these difficult conversations now can save your loved ones from making tough decisions later on.



Julie Scott, DNP
Julie Scott, DNP
Julie is an oncology certified Oncology Nurse Practitioner with over a decade of medical oncology experience. In addition to her clinical work, she is an accomplished healthcare writer providing oncology content for various publications. She also serves as an adjunct faculty member for a Master's nursing program and a chair for Doctoral nursing students.

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