Advance Directives

• Instructions
• Download Five Wishes
  For viewing only. Hard copies are available at the hospital information desk, or through Aging with Dignity.
• Part A - Appointment of a Health Care Agent
• Part B - Health Care Instructions
• Organ Donation Addendum
• Living Will
• Frequently Asked Questions (FAQ)

1. If I made a living will or durable power of attorney prior to October 1, 1993, when the new Health Care Decisions Act became effective, is it still legally valid?
   Yes.
2. Must I use any particular form?
   No. Optional forms are provided but you may change them or use different forms altogether. Of course, no health care provider may deny you care simply because you decided not to fill out a form.
3. Who can be picked as a health care agent?
   Anyone who is 18 or older except, in general, an owner, operator, or employee of a health care facility where a patient is receiving care.
4. Who can witness an Advance Directive?
   Two witnesses are needed. Generally, any competent adult can he a witness, including your doctor or health care provider. If you name a health care agent, that person cannot be a witness for any of your advance directives. Also, one of the two witnesses must be someone who (i) will not receive money or property from your estate and (ii) who is not the one you have named as the personal representative of your estate.
5. Do the forms have to be notarized?
   No, but if you travel frequently to another state, check with your lawyer to see if that state requires notarization.
6. Do any of these documents deal with financial matters?
   No. If you want to plan for financial matters, talk with your lawyer.
7. When using these forms to make a decision, how do I show the choices that I have made?
   Write your initials, next to the statement that says what you want. Don't use check marks or X's. Then draw lines all the way through other statements that do not say what you want. Please don't make inconsistent choices. For example, if you initial any or all of items 1, 2, and 3 on Part B of the Advance Directive, do not initial item 5. Draw lines through it instead. Also, be very careful about item 4. Draw lines through it if you want to make sure that you get pain relief mediation.
8. Should you fill out both the Living Will form and the Advance Directive form?
   It depends on what you want to do. If you want to name a health care agent, you should fill out Part A of the Advance Directive. The Living Will form does not allow for appointment of a health care agent. The Living Will form lets you decide about life-sustaining procedures in the event of terminal condition or persistent vegetative state. If you want to decide about life-sustaining procedures not only in the event of terminal condition or persistent vegetative state but also "end-stage-condition," or you want to make health care decisions that deal with situations other than life-sustaining procedures, use Part B of the Advance Directive form.
9. Are these forms valid in another state?
   It depends on the laws of the other state. Most states will honor an Advance Directive made somewhere else.
10. To whom should I give copies of my Advance Directive?
    Give copies to your doctor, your healthcare agent if you name one, hospital or nursing home if you will be there, and family members or friends who should know of your wishes.
11. If I have an Advanced Directive do I also need an Emergency Medical Services Palliative Care/Do Not Resuscitate Order?
    Yes. If you don't want ambulance personnel to try to resuscitate you in the event of cardiac or respiratory arrest, you must have an EMS Palliative Care/DNR Order signed by your private physician.
12. Does the EMS Palliative Care/DNR Order have to be in a particular form?
    Yes. Because ambulance personnel who may be called to assist have so little time to evaluate the situation and act appropriately, it is not practical to ask them to interpret documentation that may vary in form and content. So, a standardized State form has been developed. Have your doctor or health care facility contact the Maryland Institute for Emergency Medical Services System (AHEMSS) at 410-706-4367 to obtain information on EMS Palliative Care/DNR Orders.