Couple preparing an advance directive paperwork.

Advance Directive Clinic Helps You Set Up Living Will, Power of Attorney

March 9, 2018

Loyola Medicine pulmonologist Paul Hutchison, MDLoyola Medicine offers a new program to help patients put in writing their wishes for medical care in the event they can’t speak for themselves. The Advance Directive Clinic gives patients the time needed to learn about, discuss and complete a healthcare power of attorney, living will or other directive. Paul J. Hutchison, MD, established and leads the program.

What is an advance directive?

An advance directive is any decision you make for yourself in case you lose the ability to communicate. It puts in writing your wishes, and with your signature, it is a legal document that describes future decisions about your healthcare.

What are the types of advance directives?

The state of Illinois allows several types of advance directives, but the most commonly used are: power-of-attorney for healthcare, living will, and Practitioner Orders for Life-sustaining Treatment (POLST). 

Everyone over the age of 18 should, at the least, complete a healthcare power-of-attorney form, which appoints a trusted family member or friend to speak for you if you lose the ability to communicate.

A living will may be helpful if you are facing a terminal illness or want to be prepared in case you suffer a debilitating injury, stroke or other condition. It can specify the types of treatments you would or wouldn’t want in certain situations. The state of Illinois has a standard form you can fill out, or you can write your own living will with your physician or lawyer. 

POLST is a medical order that reflects an individual’s wishes about receiving cardiopulmonary resuscitation (CPR) and life-sustaining treatments such as medical interventions and artificially administered nutrition.

In the Advance Directive Clinic, we primarily help patients complete power-of-attorney forms. While we can answer questions about the POLST form, we encourage you to complete this with your primary care physician if it is something you wish to pursue.

Why do I need an advance directive?

You are encouraged to have an advance directive for two important reasons. First, with an advance directive in place, doctors can follow your wishes when you can’t speak for yourself. Let’s say you are injured in a car accident and brought to the hospital unconscious. The healthcare team can take better care of you by knowing the kinds of treatments you would want and whom you trust to make decisions for you.

Second, it takes the burden off family members who may be asked what medical treatments you would want. These types of decisions can be stressful for family members. With an advance directive in place, your family will know what you want, so they are not left hoping they made the right decision for you. It helps your doctors and family choose treatments that are in your best interest based on what you have shared in your advance directive.

When is the best time to set up an advance directive?

The best time to complete an advance directive is now. You need to complete an advance directive when you are healthy. If you lose the ability to think clearly and communicate, you will not be able to complete one.

Who should be involved in creating my directive?

Ideally, you would include trusted family members or friends in the process. If you choose a healthcare power of attorney, you should let that person know and make sure they are comfortable being in that role. Also, give your primary care physician a copy of the advance directive.

What if I’m too sick to decide what to do and I don’t have anything set up?

If you fall ill and lose the ability to communicate, your decision-maker is assigned to you based on state law. In Illinois, the decision-maker is selected in this order: legal guardian, spouse, adult children, parents, adult siblings, grandchildren, and close friends.

How does the clinic work?

At an Advance Directive Clinic appointment, I meet with you, your trusted friend or family members and a member of the clinic team. All clinic visits are scheduled for 30 minutes, which allows ample time to complete an advance directive, discuss your values and answer questions about your future.

First, we go through the power of attorney form step by step. If you feel comfortable with the form and wish to sign it, we can provide someone to witness your signature, which will make the document official. A copy will be scanned into Loyola's electronic medical record.

Then, we discuss your values and preferences for medical care. This crucial conversation helps family members and Loyola's healthcare team understand how you would like to be cared for if you were ever to become ill.

Most insurance plans provide coverage for this visit, although co-pays and deductibles may apply.

Why did Loyola decide to start an advance directive clinic?

Loyola is committed to the inherent worth and dignity of all our patients. Respecting an individual's personal values, wishes and sense of dignity is an important part of this commitment. We recognize that visits with your primary doctor may be too short to address all of your questions and concerns about advance directives. 

How common are these types of clinics?

While many hospitals have resources for patients to complete an advance directive, we are not aware of any other hospital that offers a dedicated, one-on-one consultation with a physician who is trained in medical ethics. 

To make an appointment with Dr. Hutchison’s Advance Directive Clinic at Loyola Outpatient Center, call 888-584-7888, or ask your primary care doctor to refer you.

Paul J Hutchison, MD, MA, is a pulmonary and critical care physician who cares for patients in Loyola University Medical Center’s intensive care unit. He is an assistant professor of medicine and bioethics at Loyola University Chicago’s Stritch School of Medicine.