Tag Archives: health care directives

Health Care Directives


Living Wills and Health Care Power of Attorney forms are two common health care directives.    Here are some other health care directives you should know about:

Q. Why do you need a DNR?

A. A Do Not Resuscitate (DNR) order is a request not to have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing.   Unless paramedics or other emergency staff are given other instructions, paramedics and hospital staff will try to resuscitate a patient whose heart has stopped or who has stopped breathing.


Q. Why do you need to complete a living will and a DNR?

A. The directions in your living will are only followed when your doctor believes you are in a terminal state and will not recover from your illness or injury.   The directions in your DNR are effective the moment you sign them and do not require any type of medical condition to be present for the DNR to be effective.

Elderly people sometimes want a DNR if they suffer from chronic illness and are concerned that their quality of life will suffer if they require resuscitation.


Q. What happens if the paramedics do not know you have completed a DNR?

A. If the paramedics or other medical personnel cannot locate your DNR, they will make an effort to save your life.


Q. How can you help the paramedics make the right treatment choices.

A. You can help the paramedics in several ways.

  • Participate in the Vial of Life program, a nationwide effort to assist emergency personnel administer proper medical treatment for you when you can’t speak for yourself.
    • A  vial of life sticker is placed on your door.  This sticker tells the paramedic to look for your DNR and other medical information in a vial placed in your refrigerator.
  • Some people recommend storing the DNR in the freezer in a blue bag, as paramedics are trained to look in the freezer for DNR documents stored in a blue bag.
  • Some states authorize the use of identification bracelets or tags as a way  to notify medical personnel that you have signed a DNR.


Q. What is HIPPA?

A. HIPPA is the acronym for the Health Insurance Portability and Accountability Act passed in 2003.  In an effort to protect our privacy, HIPPA restricts the freedom of medical care providers to share medical information about you without your consent.

The provisions of HIPPA give you the right to view information contained in your medical records and to designate other persons with whom your medical information may be shared.


Q. What if you have not completed a HIPPA form giving someone the right to view our medical records?

A. Without a written authorization from you, medical professionals and medical facilities fact stiff penalties for violating HIPPA.

Without advanced authorization by you, your health care agent, spouse, family and others will not be able to access your medical records to make an informed decisions about the best plan of care for you.

FACT.  HIPPA and adult children

If an adult has a child attending college, they should consider having the child sign a HIPPA form giving their parent the right to access their medical records.   Otherwise, if the student is in an accident, the parent may not have the right to iew the child’s medical records to make decisions about their care.


Q. What is In Case of Emergency (ICE)?

A. If you are in a car accident or other accident requiring unexpected medical care, the physicians and emergency personnel must find a way to contact someone regarding your medical emergency.  Time is important.  Some medical procedures require authorization from a spouse or a health care agent before treatment can begin.  A shorthand process has been developed to facilitate this communication process, referred to as ICE.

Q. How does ICE work?

A.  ICE reflects the list of persons who you want contacted in case of an emergency.   This list of persons and their telephone numbers is stored on your cell phone.   The steps are as follows:

  • Decide whom you want contacted in case of emergency
  • Enter ICE as the contact name in your cell phone contact list
  • Add the phone number of the person ou want called in case of emergency
  • If you want to name more than one person, make an ICE1 and ICE2 entry in your contact list.

Paramedics and other emergency responders are trained to examine your cell phone and look under “ICE” for information on who to contact.


Let’s talk about dying!

Today is National Health Care Directives Day.   A day to talk about death.    A day to talk about Living Wills and Health Care Power of Attorney forms, referred to as advance health care directives.

Why is it important to talk about dying and health care directives.  It’s simple.     We will all die.   However,  the way we will die will be different than the way our grandparents died.   They died fast, due to acute illnesses like influenza or pneumonia.  A government study envisions that today, 80 percent will die a lingering death from things like Alzheimer’s, emphysema, cancer and Parkinson’s.   Our children or our spouse will need to make choices on our behalf between life…and quality of life.

When having dinner with your friends or family tonight, think about that sobering number.   Three out of the four people sitting at the dinner table will die a lingering death.    Someone will need the legal authority to make health care choices on your behalf.   Someone will be hoping they are making the choice you would have wanted.

Rather than talking about the  engagement ring Brad gave Angelina….make your dinner conversation important.    Ask yourself these questions:

  • Who do you want to make health care choices on your behalf?
  • What choices do you want them to make?
  • Do you want to donate your organs or your tissues?
  • Have you completed a living will and a health care power of attorney form documenting these wishes.   If so, where are they?    In California and some other states, these two forms are combined in a single form referred to as an Advance Health Care Directive.

Your estate planning lawyer can help you complete a Living Will and a Health Care Power of Attorney form.     You have the right to complete these forms without involving a lawyer.

Hers’s some resources that may help you start the discussion:

A great presentation by Dr. Peter Saul at the TED conference called “Let’s talk about dying.”
When families can’t agree what to do:   A personal experiences described in the San Jose Mercury News:  http://www.mercurynews.com/cost-of-dying/ci_20403982/national-day-support-end-life-health-care-planning
Where Can You Get Free Health Care Directive Forms:   https://diesmart.com/elder-law/living-wills/