ADVANCE HEALTHCARE DIRECTIVES ATTORNEY
IN CORPUS CHRISTI, TEXAS

When most people think about estate planning, they think about wills and living trusts. However, advance healthcare directives are among the most vital estate planning documents you can have. A will that directs the distribution of your estate when you die is important, but so is a will that tells others what your wishes are for healthcare while you are alive should you be unable to express them on your own.

As an estate planning attorney, I want people to understand advance healthcare directives. If you do, you will know how important they are to your estate plan. I help clients with estate planning in Corpus Christi, South Texas, and the Coastal Bend area, as well as Aransas, Kleberg, Bee, Nueces, Live Oak, Jim Wells, and Victoria counties. At Russell Manning Law PLLC, I can help you, too.

WHAT IS AN ADVANCE HEALTHCARE DIRECTIVE?

An advance healthcare directive is also known as a “living will.” It is a legal document you create that expresses your wishes regarding medical intervention in situations where you are unable to communicate those wishes for yourself.

The living will describes what measures you want to be taken and what measures you do not want to be taken if you are comatose, have a severe illness, are in an accident, or suffer from dementia. In these states, you may not be able to make those decisions and tell your doctors what you want. A living will provides a way to make such important decisions now, while you are able to do so.

A living will addresses a number of issues regarding end-of-life and lifesaving care. These include such measures as cardiopulmonary resuscitation, use of a ventilator, administration of drugs, surgery, blood transfusions, dialysis, administration of food and water, and pain relief. It can also address organ donation.

Any adult age 18 and older can execute an advance directive and should, regardless of your health now. You never know when you may suffer serious injury or illness, so it is wise to have one at all times.

WHAT IS A HEALTHCARE REPRESENTATIVE?

A durable power of attorney for healthcare usually accompanies a living will. You appoint someone to ensure that your wishes regarding lifesaving and end-of-life care are honored. You can name any adult to serve as your healthcare representative, but given the gravity of the responsibility, it should be someone in whom you place enormous trust to act on your behalf as you have specified.

Your healthcare representative will have the legal authority to consent or not consent to certain medical measures and procedures, retain or dismiss medical personnel, choose a care facility for you, and if necessary, obtain a court order on your behalf to ensure your wishes are carried out. The durable power of attorney also allows your healthcare representative to be privy to all medical records and other information and ensures the representative can visit you regardless of the facility’s visitation policies.

WHAT IS A DNR ORDER?

A do not resuscitate order, usually referred to as a “DNR,” is perhaps one of the least understood advance healthcare directives. If you have been admitted for even a minor outpatient surgical procedure, you have probably been asked if you want to sign one.

A DNR states that you do not want CPR or other lifesaving measures performed should you need them. DNRs are usually executed by those who are critically ill and whose conditions will never improve. DNRs are not usually appropriate for people who are not critically ill. Most people will want to be resuscitated should they stop breathing. 

Then, the living will dictates wishes regarding additional care, including whether or how long they wish to be reliant upon a ventilator if they cannot breathe on their own following resuscitation. You should definitely discuss DNRs with your doctor.

WHAT IS A POLST FORM?

The physician orders for lifesaving treatment, or “POLST,” is another advance healthcare directive. A POLST is similar to a DNR, advising emergency responders and medical personnel about your wishes regarding lifesaving measures. A POLST addresses a broader set of measures than a DNR.

The POLST covers issues such as intubation, use of feeding tubes, administration of antibiotics, and other measures that are taken immediately in emergent circumstances. As with the DNR, the POLST is not a substitute for a thorough living will because they are limited in scope.

CAN I MODIFY MY ADVANCE HEALTHCARE DIRECTIVES?

Modifying an advance directive is always your prerogative, so long as you have the mental capacity to do so. As you get older or as your health conditions change, you should revisit your advance directives to ensure they still reflect your wishes. You may also want to change who you appoint as your healthcare representative in a durable power of attorney for healthcare.

For example, you may want to execute a DNR should you become terminally ill. Alternatively, if you were critically ill and recovered, you will likely want to rescind a DNR and rescind or modify a POLST.

It is a good idea to review your advance directives periodically with your estate planning attorney and discuss their impact with your doctor should your health condition change.