Your palliative care team at NYU Langone can help you put together your advance directives. These are written affirmations of who you want to make healthcare decisions on your behalf, should you become unable to do so. They can also include the written expression of your care plan.
By completing the appropriate advance directives, you can make choices about your future medical care. Our palliative care experts can help you understand the consequences of your choices and help create a plan that best fits with your values and personal wishes.
There are several types of advance directives. At the hospital, we help you to complete a health care proxy. If you have a living will, we assist you in completing additional forms that may be needed in the hospital setting in order to carry out your wishes as stated in your living will.
A living will is a written document that informs healthcare providers of the medical services you would or would not want to receive if you lost the capacity to make your own medical decisions. It should not be confused with a last will and testament, which deals with your estate. Rather, a living will only addresses your medical care.
An attorney can help you put together your living will. When complete, please give a copy to your doctor so the information can be kept in your medical chart.
Health Care Proxy
A health care proxy allows you to select the person you would like to make medical decisions for you if you become temporarily or permanently unable to do so for yourself. This person is known as your healthcare agent. This can be a family member, friend, or anyone who knows your wishes and you can trust to carry them out.
Making Important Healthcare Decisions
Your doctor can help you determine which end-of-life treatments you would want and which you would prefer to forgo. You can then discuss those decisions with your healthcare agent.
Topics to consider include:
- Whether you would want life-prolonging treatments, such as a ventilator (breathing machine), dialysis, artificial nutrition (feeding tube), and cardiopulmonary resuscitation (CPR). If you have a terminal illness, these interventions are not intended to cure your disease, and in some instances may only prolong the dying process. You should also address whether you would want these treatments if you had an incurable disease, or were in a persistent vegetative state or a permanent coma.
- A “do not resuscitate” (DNR) or “do not intubate” (DNI) order may be placed when you advise your medical team that, if your heart stops beating (cardiac arrest) or if you stop breathing (respiratory arrest), they should not attempt to revive you by either CPR or artificial ventilation. A DNR or DNI order is entered by your physician when you sign a consent form or give verbal consent to the DNR or DNI order in the hospital.
- Whether you would want artificial nutrition or hydration, in which intravenous (IV) fluids and a feeding tube are used to deliver nutrition and fluids when you are no longer able to feed yourself. You can opt not to have these medical interventions.
You can download the New York State Health Care Proxy form. Your palliative care team is available to talk you through your decision on each of these topics.