Building Your Advanced Directives
For building your Advanced Directives, we recommend utilizing Five Wishes found at https://fivewishes.org. Five Wishes is a complete approach to discussing and documenting your care and comfort choices. It's about connecting families, communicating with healthcare providers, and showing your community what it means to care for one another. The documents for Five Wishes are legally binding in the State of Alabama. The document allows you to express:
The person you trust to make decisions for you
What types of medical treatment you would want - or not want
What is most important for your comfort and dignity
What important spiritual or faith traditions should be remembered
What you want your loved ones and healthcare providers to know about you
Five Wishes has changed the way we talk about advance care planning by ensuring that it is not just an end-of-life planning tool, but the beginning of an important family conversation. Benefits include:
It's written in everyday language, making it easy to understand and complete
It covers personal, spiritual, medical, and legal wishes all in one document
It allows your family or caregiver to know exactly what you want, relieving them from the difficult position of guessing your wishes
The document includes all the instruction and information needed to create a valid advanced directive
The Five Wishes Advanced Directive costs $5.00 to purchase and download online for you to complete by hand. You can also choose an online approach to building your Five Wishes Advanced Directive for $10. For those that need additional information to better explain the details of the Five Wishes plan, a Starter Kit is available for $24. Their store has many additional resources for purchase should you wish to obtain them.
You can also create Advanced Directives for free online utilizing the services of Law Depot or Rocket Lawyer. Legal Zoom is an additional affordable option for building an advanced directive for the price of $39. An attorney can also assist with the build out of forms at an additional fee. Generally, these fees can cost from $150 - $300.
Some physician practices may also have the paperwork to get you started, and they can also answer any questions you might have about certain procedures that prolong life. Whether or not you have questions, once you have completed your Advanced Directives and named your Health Care Proxy, you should take copies to all doctors' offices to keep in your file as well as go over your decisions for those providing you with care.
Keep these things in mind when preparing to document your Advanced Directives:
Identify the person you want to make care decisions for you when you can't
Provide the kind of medical treatment that you do and don't want
Include what comfort measures you may want to have in place
Let people know how you want to be treated
Give your loved ones the gift of knowing what you wish
Remember, you can be as detailed and thorough as you want to be with your directives. Also, remember that you can change your mind on these directives as well. These advanced directives only go into play after your attending doctor finds you are no longer able to make health care choices yourself, and another health care professional agrees that is true.
In Case of an Emergency
If you have a medical emergency and ambulance personnel arrive, they may look to see if you have a DO NOT RESUSCITATE form or bracelet. Many states require a person to have a DO NOT RESUSCITATE form filled out and signed by a doctor if you choose not to be resuscitated. This form lets ambulance personnel know that you don't want them to use life-support treatment when you are dying. Please check with your doctor to see if you need to have a DO NOT RESUSCITATE form filled out.
Comfort and Treatment Care
Just as importantly, you can provide information about your personal, spiritual, and emotional wishes. You should be treated with dignity near the end of your life, so providing details can help to ensure that it can happen. Putting that into place while you have sound mind and body is important.
Signatures and Witness Statements
It is important to make sure you gain all important signatures, including yours and your assigned choices for Health Care Proxy. While Advanced Directives in the State of Alabama are not required to be notarized, they do require two witnesses. The witnesses must also be over the age of 19. Witnesses cannot be:
The individual appointed as (proxy) by this document or his/her successor
The person's health care provider, including the owner/operator of a facility serving the person
An employee of the person's health care provider
Financially responsible for the person's health care
An employee of a life or health insurance provider for the person
Related to the person by blood, marriage, or adoption
A beneficiary of any legal instrument, account, or benefit plan of the person
A creditor of the person entitled to any part of his/her estate under a will
Make sure you sign and witness the form just the way it says in the directions of your Advanced Directives and Health Care Proxy for it to be legal and valid. Talk about your wishes with your Health Care Proxy, family members, and others who care about you and give them copies.
Keep the original copy you signed in a special place in your home and keep it nearby so that someone can find it when you need it. If you choose to utilize Five Wishes to build your directive, you will be provided with a wallet card that you can complete, carry with you, and let people know where you keep your Advanced Directives.
Be sure to talk to your doctor during your next office visit. Give your doctor a copy of your Advanced Directives. Make sure it is put in your medical record. Be sure your doctor understands your wishes and is willing to follow them. Ask him or her to tell other doctors who treat you to honor them.
If you are admitted to a hospital or nursing home, take a copy of your Advanced Directives with you. Ask that it be put in your medical record. Record who all you have given copies to of your Advanced Directives.
Additional Guidance on Completing an Advanced Directive
Below are some additional resources you can consult while building your advanced directive:
Published by the Center for Practical Bioethics, guide helps individuals and their families share meaningful conversations regarding end-of-life decisions.
Developed by the American Bar Association Commission on Law and Aging.
Guide prepared by Heart Tones addressing historical, cultural and spiritual factors that influence African-Americans' decisions about end-of-life care and planning.
A community education program helping people understand the importance of planning for their end-of-life medical care, this comprehensive advanced care planning program developed by Georgia Health Decisions includes the CRITICAL Conditions Planning Guide.
Workbook and video created by California advocates with development disabilities.
Internationally-recognized, evidence-based program established in 2000 addressing process of advance care planning.
Online course developed by Carolina Geriatric Education Center that provides evidence-based and culturally-competent geriatrics education and training.
Guide published by American Bar Association Commission on Law and Aging.
Guide published by Compassion and Choices.
Offers free access to over 4,000 pages of educational materials about end-of-life care, palliative medicine, and hospice.
Initiative encouraging individuals to express their wishes regarding health care; provides variety of resources, including materials for public, media kits, and suggested activities.
Offers several videos on death and dying that provide information to help seniors and their caregivers help themselves.
Electronically stores advance directives and makes available to health care providers 24 hours a day via secure internet or telephone-facsimile; also stores organ donation.
Free downloadable advance directive forms and information from state bar associations and other reputable state groups.
Website of the National Library of Medicine (a part of the National Institutes of Health) offers easy-to-understand information on advance directives.).
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