Many people are confused about the differences between Living Wills (also called Advance Directives) and a Health Care Proxy.
Simply put, Advanced Directives– or Living Wills– indicate your wishes for medical care, particularly with regard to artificial life sustaining procedures, in writing, while you are capable of making your own decisions. A Health Care Proxy is the person you choose to make health care decisions for you if you are unable to make decisions for yourself.
There are several different types of Advanced Directives approved for use in New York State. While you do not need an attorney to complete these forms, you may wish to consult an attorney to determine which form is best for your particular needs.
The New York State Living Will and Health Care Proxy forms are available online from the New York State Bar Association.
Another more detailed type of Living Will is called Five Wishes. Five Wishes is a document that considers your personal, emotional and spiritual needs as well as your medical wishes. It also lets you choose the person you want to make health care decisions for you if you are not able to make them for yourself. The Five Wishes form is accepted in New York State and is also available online.
MOLST–Medical Orders for Life Sustaining Treatment– is an advanced directive generally used when an individual has a serious health condition or is facing the end of life. The MOLST document is a brightly colored form that is easily recognizable by healthcare professionals. It should be kept in a location where it can be easily seen or found by your loved ones, emergency responders and other health professionals.
What most people do not know is that Emergency Medical Technicians cannot honor living wills or health care proxies outside of a health care facillity.
When they are called to a home, EMTs must do whatever is necessary to stabilize a person for transfer to a hospital unless there is a non-hospital Do Not Resuscitate order. Because a health care professional must complete the MOLST form, it becomes a medical order which all health care professionals must follow, regardless of whether a person is at home or in a health care facility. That is why it must be readily available in case of a medical emergency.
Choosing a health care proxy and accepting that responsibility requires serious thought. The person you choose should not be afraid to ask questions from healthcare providers in order to get the information they need to make decisions on your behalf. Since your health care proxy will be making decisions based on your values and your views, you should have in-depth conversations with him/her over time as your wishes may change.
Being a healthcare agent can be difficult. We hope we never have take action. A client once compared being a health care proxy to sitting in the emergency exit row on an airplane – when you book the seat, you are capable enough, are willing to take on the responsibility and have all the good intentions of being able to follow through with the instructions you have been given. Given the emotions of the moment, however, would you actually be able to carry them out?
Families often experience uncertainty, grief and conflicting viewpoints about their loved one’s wishes when they are unable to make those decisions for themselves. Your health care agent should be someone you know well and can trust to act on your behalf in stressful situations.
Some things to remember:
- Make sure you sign and witness the forms so your wishes will be legal and valid.
- Talk about your wishes with your health care agent, family members and others who care about you. Give them copies of your completed documents.
- Advance Directives do not expire, so they should be reviewed periodically to make sure that your wishes have not changed.
- Keep the original copy you signed in a special place in your home. Do NOT put it in a safe deposit box. Keep it nearby so that someone can find it when you need it.
- Talk to your doctor during your next office visit. Be sure your doctor understands your wishes and is willing to follow them.
- If you are admitted to a health care facility, take a copy of your document with you and ask that it be made part of your medical record.
For more information on making health care decisions see Deciding About Health Care