What is the Difference Between a Do Not Resuscitate Order, a Living Will and a Durable Power of Attorney for Health Care?

All of these documents are considered advance directives with important differences.

Do Not Resuscitate Order

This advance directive simply states that you do not want to be brought back to life through cardiopulmonary resuscitation (CPR) if you stop breathing or your heart stops beating. People who generally request this order have a pre-existing condition that is chronic and that will eventually cause death such as but not limited to cancer, severe heart disease, or systemic problems with the liver or kidneys. Your physician will be able to provide a form for you and will note this on your chart if you wish to enact a Do Not Resuscitate Order. There are bracelets and forms to be placed in easily viewed areas of the home stating these wishes in the event that paramedics have to come into your home. To better understand a DNR and to assist in determining if this is the best advance directive for you, and to understand the laws governing the DNR in the state that you reside, discuss this option with your physician.

Living Will

This document takes effect when an individual is deemed terminally ill. “Terminally ill” is defined as having six months or less to live. A living will describes the treatments that you want in place for yourself in the event that you are unable to communicate your wishes to medical personnel during that time. This document DOES NOT allow for you to appoint a representative to make decisions for you when you cannot make decisions for yourself, but will detail your specific wishes in the document. The living will is especially helpful if there is no one that you trust to make decisions for you. In some states if a Living Will and a Durable Power of Attorney are in existence a Living Will may override the Durable Power of Attorney for Health Care unless you specify in writing that you do not want this to be the case.

Durable Power of Attorney for Health Care

This is the most comprehensive legal document of all of the advance directives. A person whom you trust is appointed to make certain decisions when you can no longer do so. A Durable Power of Attorney can include an alternate decision maker or two decision makers to ensure that your wishes are carried out. This document only becomes active if you are unconscious or unable to make medical decisions and DOES NOT put another person in charge of medical care while you may make decisions for yourself. If using this document it is highly recommended that you write down in detail what you would like to happen in the event that you can no longer make your own decisions. This takes the pressure off of the person or persons that you designate to make difficult decisions on your behalf. This will alleviate confusion and guilt for all parties concerned.

Investigate Your State Laws Regarding Advance Directives

Before finalizing your wishes through the advance directive right for you, make sure you investigate the legalities of your decisions. Your document could be dismissed if it includes certain wishes that are not legal in the state that you reside. If at all possible, you should have an attorney review your advance directive. Access downloadable versions of state-specific advance directives at The National Hospice and Palliative Care Organization’s website nhpco.org. You may also obtain specific forms or resources pertaining to advance directives in your state through the local hospital, the area agency on aging or geriatric care manager in your area.

Keep the Copy of Your Advance Directive Easily Accessible

What good is a legal agreement if no one knows about it? Many people mistakenly put the original copy in a safety deposit box that may not be accessible in an emergency situation. Make sure family members and loved ones who would become involved in your care have copies of your advance directive and that they know where you keep the original certified copy. (Some states do not consider a duplicate to be a legally binding document.) If you have an appointed representative for the Durable Power of Attorney for Health Care, make sure this person also has a legally binding copy of the document. Request that your physician keep your advance directive on file.

Advanced Directives Will Restore Peace of Mind For You and Your Loved Ones

During Difficult Times The last thing anyone wants is for their demise to cause enduring pain and hardship, battles over what is best, and feuds that can tear a family apart forever. No matter how young you are or how healthy you are, this small, yet uncomfortable step reminding us of our mortality may lessen the heartbreak of an unexpected trauma for loved ones. The gift that Terri Schiavo has given all of us is the ability to discuss with our loved ones what we desire, and to take action through advance directives, relieving those closest to us the responsibility of making impossible decisions for our care. It is never too early or too late to make these decisions.