While medical technologies push life-saving and sustaining abilities to new frontiers, age or unfortunate circumstances may still put us in a position where we must make difficult decisions surrounding how we wish to receive treatment.
There are two forms that allow you to remain in the driver’s seat of your health care when you’re unable to speak for yourself — a medical power of attorney and a living will. The trouble is, these documents are often confused for one another when the purpose of each is notably different.
In this article:
- Medical Power of Attorney
- Living Will
- Advance Directive
- Chart: Key Differences
- Where to Record Your Health Documents
- Video: Medical POAs and Living Wills
Medical Power of Attorney
A medical power of attorney, which is also called a health care power of attorney, a health care proxy, and an advance directive, is a document that designates a health care agent who will make important medical decisions for you in the event that you cannot do so yourself. These decision-making “powers” only activate once an unfortunate medical matter should befall the principal, such as:
- severe Alzheimer’s disease;
- dementia;
- a vegetative state;
- a coma; or
- another type of incapacitating event
The document, which is typically notarized, allows someone you trust to act as your health care representative. They then help make certain that physicians and other medical staff understand and carry out your wishes.
Naming a Medical Power of Attorney
When choosing your medical power of attorney, it’s important to sit down with your intended health care agent and discuss your medical wishes in detail. They should be familiar with your medical history and any current or past complications, as well as any future responsibilities or decisions they may face. Health care agents are typically very close family members, and it’s also possible to have more than one. Most of your health care wishes should be written out in a living will so that your agent has a definitive guide to follow.
Living Will
A Living Will, which is also called an advance directive, is a form where an individual lists out medical decisions that may arise during incapacitation or end-of-life care. The purpose of this document is to direct physicians with specific care instructions, especially with instances of resuscitation, or DNR (do-not-resuscitate) instructions.
Without this document, and if a healthcare proxy is not designated, it’s difficult to judge an ill or incapacitated person’s end-of-life wishes.
Here are some matters you will want to evaluate while creating your living will:
- Resuscitation
- Surgical treatments
- Mechanical ventilation
- Nursing home treatment/care
- Tube feeding
- Hospitalization
- Use of antibiotics
- Psychiatric treatment
- Requests not to transfer to an emergency room
- HomeStay care
- Pain management
- Organ donation
Advance Directive
When searching for medical powers of attorney and living wills, you will almost certainly happen upon the term advance directive. The word is sometimes used interchangeably with living will because it also provides medical staff with directives as to how to handle your end-of-life-wishes. A medical power of attorney can also be considered an advance directive because it assigns someone else medical powers before, or in advance, of an incapacitating event. But some states may use terms differently, which is part of the reason why this topic can be a bit confusing.
Chart: Differences Between Medical POA and Living Will
| Medical POA | Living Will | |
| What is it? | A person (your healthcare agent) | A list of medical directives |
| When does it become active? | Upon incapacitation | Upon incapacitation |
| When does it become inactive? | Upon death or when the principal becomes of sound mind | Upon death or when the principal becomes of sound mind |
| Is it a type of advance directive? | Yes | Yes |
Where to Record Healthcare Documents
After you’ve created your documents, they’re essentially worthless if no one has access to them. Thankfully, there are a few things you can do to make sure people that need these instructions can get them.
- First and foremost, you’ll want to have them scanned into your medical record at your local hospital.
- Then, submit the documents to the United States Advance Care Plan Registry (USACPR), which holds a digital copy of your directives that providers with your identifying information can access.
- Finally, inform a trusted family member that you have medical directives and give them a copy. You can also carry a copy on your person if you wish to do so.