6 myths about advance directives

An advance directive is a written legal document that allows you to communicate your wishes for your health care in the event you are no longer able to make medical decisions for yourself.

Social work counselor Mark Anderson has years of experience working with patients on advance care planning, which includes advance directives. Here, he dispels six common myths about advance directives.

Myth #1: The Living Will and Medical Power of Attorney are the only types of advance directives.

Fact: While these are some of the most common types of advance directives, they are not the only ones. Here’s a breakdown of advance directives as well as examples of other advance care planning documents.

• Medical Power of Attorney: This allows you to name someone to make decisions about your medical treatment if you’re no longer able to do so. You can name up to two alternates, and that power would only go to the alternate if the first designated person is unable to make those decisions.
• Living Will: This allows you to state what kind of medical care you want to receive or avoid if you are unable to make these decisions for yourself and doctors determine your condition is terminal or irreversible. For example, you can state that you simply want measures to keep you comfortable in those situations, or you can ask that the doctor do everything they can to extend your life.
• Out-of-Hospital Do Not Resuscitate Order: This provides instructions for emergency personnel outside the hospital. If you have this form, they will not perform life-sustaining treatments on you if your heart stops or you stop breathing. However, if you fill out the form in Texas, for example, it’s only valid in Texas. If you cross state lines, you’re required to complete a new document in that state.
• Appointment of Agent to Control Disposition of Remains: This allows you to name someone to make decisions about what happens to your body after you die. The form requires the signature of the person taking responsibility for your body.
• Declaration for Mental Health Treatment: If you have a chronic mental illness, this allows you to make decisions in advance about your mental health treatment if you’re unable to do so.

The following forms focus on your financial well-being:

• Last Will and Testament: You can share your final wishes as they relate to your possessions, including who will receive what and in what amount.
• Durable Power of Attorney: This form allows you to designate someone to make decisions about your finances if you’re unable to do so.

Myth #2: You need a lawyer to complete advance directives.

Fact: Medical advance directives are designed to be easy to fill out. You do not need a lawyer to fill out these forms. However, we do recommend consulting an attorney if you are completing a Last Will and Testament or Durable Power of Attorney.

Myth #3: Once you complete an advance directive, you aren’t allowed to complete a new one.

Fact: While you cannot alter the original document, you may complete new forms that would supersede any previous ones. You may want to complete a new form if there are major changes in your health or personal life, such as marriage, divorce, death of a spouse or progression of your own illness.

Myth #4: These are personal documents, so you should be the only one with a copy.

Fact: These documents are important, so you should keep the original copies in a safe place. Each person named in the document (e.g., your medical power of attorney) should get a copy as well as your doctors and any caregivers.

Myth #5: You should only complete advance directives when you’re very ill or near the end of life.

Fact: It’s best to start thinking and talking about what’s important to you early and also if your goals change. You are encouraged to talk about what matters most with your caregivers, friends, those who represent you, and your health care team throughout your care. Advance directives provide instructions for your medical care that reflect your goals when you’re unable to do so. You never know what could happen in life, so it’s best to be as prepared as possible.

Myth #6: If you have a Living Will, you won’t get the best medical care possible.

Fact: Some people think that by stating their specific medical wishes, it will be interpreted as they don’t want care. This is not true. A Living Will is a document that states what you want in the event you can’t make decisions for yourself and your condition is either terminal or irreversible. It’s not meant to direct your care when you can participate and make decisions. 

Bottom line? Taking the time to put together advance directives makes it easier on you, your family and your caregivers because you’re making your health care preferences known ahead of time. Every patient is empowered to play an active role in their care. This includes talking to your care team and loved ones about what matters most to you, and having these conversations early and often. If you’re an MD Anderson patient and would like assistance with advance care planning or advance directives, reach out to your social work counselor or contact Social Work by calling 713-792-6195.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.