Advance Directive

What You Need to Know About Advance Directives

What are Advance Directives?

Advance directives are legal documents that help assure that you will be cared for as you wish, when and if you are incapacitated. They apply only to the care given to you after you are incapacitated, i.e., when you are no longer able to make decisions on your own.

There are two kinds of advance directives: instruction directives (“living wills”) and proxy directives in which you designate a person with “durable power of attorney” to make decisions on your behalf.

Many people choose to combine these two kinds of directives, stating their general preferences and designating an agent to make specific decisions.

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Why would I want an Advance Directive?

Modern medical technology gives us many options not available just a few years ago. Some of those options may be ones that we would not choose, especially if the chances of recovery were very poor. These choices involve values and individual preferences, as well as objective information. Your physician needs to know your wishes in order to treat you appropriately.

Stating your wishes in writing may make it easier for your family members to fulfill their part in caring for you. Either through a “living will” or by appointing one of them to be the principal decision maker, you can ease their burdens at what may be a difficult time.

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Why should I consider this now?

It is never too early for an adult to communicate values and preferences to family members and health professionals. Though fortunately rare, accidents and sudden illness can strike even those who are young and healthy.

Federal law requires that you be asked whether you have an advance directive whenever you are admitted to a hospital or other healthcare institution. Many people are now drafting advance directives soon after entering a hospital. Most physicians (and others) believe that the best time is not at the point of admission, but precisely when we are not sick or rushed or preoccupied with other concerns.

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What kinds of decisions can I make at this point?

Your advance directive becomes effective only when you are unable to decide for yourself. Since it is usually hard to predict the exact circumstances that might be present at that time, advance directives are typically general.

Still, you might consider whether you would want to have your life sustained by machines if you are critically ill and near the end of life. You also might consider whether artificial nutrition and hydration (fluids) should be administered through a tube directly into your stomach after you had suffered irreversible brain damage.

If such circumstances seem too remote or uncertain to consider, you may want simply to think carefully about who you would want to make such decisions on your behalf. That person can be designated as your healthcare representative (“agent” or “proxy”) to make decisions if and when you cannot decide for yourself.

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How can I obtain these documents?

Forms for both kinds of advance directives may be obtained by calling the Patient Representative Department at (973) 322-5164.

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How can I get answers to my questions and help in filling out the documents?

Written information will accompany the forms you obtain through Saint Barnabas Medical Center. Other material and alternate forms may be available through your church or synagogue. You may wish to talk with your physician. This is particularly advisable if you are under active care for a chronic disease. You may wish to consult your attorney for this purpose, although it is not necessary.

Most importantly, you should discuss these matters with the persons closest to you, those who would be involved in the event of your serious illness.

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Who else should have a copy of these documents?

If you complete an advance directive, give a copy to your doctor and a copy to your proxy. You might show a copy to others in your family as well. Some churches and synagogues maintain files.

Take a copy with you any time you are admitted to Saint Barnabas or another hospital.

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Other Resources at Saint Barnabas

Your physician and other healthcare professionals at Saint Barnabas know that these decisions are not easy. We maintain a wide range of specialized resources to help patients and their families. Among them are:

  • An Ethic Consultation
  • Patient Representatives
  • Pastoral counselors of all major faiths
  • Medical and Surgical Consultations
  • Psychologists and Social Workers
  • Support Groups

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