MyDirectives

Getting Started with an Emergency, Critical and Advance Care Plan

Emergency, Critical and Advance Care Plans, and Advance Medical Directives

Advance medical directive is a general term for any document you use to give instructions on the medical treatments you would want or not want under particular conditions. You can also use an advance directive to choose someone to make medical treatment decisions for you if you can't make or communicate those decisions yourself. The two main types of advance directives in the United States are living wills and medical powers of attorney. You can change your advance medical directives at any time and even revoke them completely. Your current wishes, provided that you are able to express them and understand the consequences of treatment decisions, take priority over written or recorded expressions of your medical treatment goals.  That includes both advance medical directives and your emergency, critical and advance care plan created using MyDirectives.

A living will is a type of advance medical directive in which you state your wishes about medical treatment should you be at the end of life and unable to make and communicate your choices, or should you be determined by a court to be incompetent. A living will may also be called a directive to physicians and family, a healthcare declaration, a medical directive, or an advance decision.  Remember, under the laws of most countries and states, a living will only takes effect when you are determined by a physician to be terminally or irreversibly ill (as a result of injury or disease, and as defined in law) and you lack decision-making capacity. As long as a terminally or irreversibly ill patient is able to make decisions and communicate with the physician, the living will is not active. In contrast, MyDirectives' Universal Advance Digital Directive (uADD)™ includes medical treatment preferences usually included in living wills, but it is a higher quality document that doctors and nurses can access and consider any time you suffer a health emergency and are unable to communicate with family, caregivers or medical personnel.

A medical power of attorney is a form of advance medical directive that you use to appoint someone else to make decisions about your medical treatment if you are unable to make and communicate medical treatment decisions yourself, or if you are determined by a court to be incompetent. This type of advance medical directive may also be called a healthcare proxy, a durable power of attorney for healthcare, or an appointment of a healthcare agent. The person appointed may be called a healthcare agent, surrogate, attorney-in-fact, or proxy.  The Universal Advance Digital Directive (uADD)™ includes the designation of a primary healthcare agent and up to two alternates, but it is better than a medical power of attorney because it can be located, retrieved, accessed, and considered any time you suffer a health emergency and are unable to communicate with family, caregivers or medical personnel.

An advance medical directive is any document that allows you to give instructions about future medical treatment preferences in case you become unable to make decisions on your own behalf or can't communicate your wishes, or if a court determines that you are incompetent. A living will is just one type of advance medical directive that allows you to document your wishes about medical treatment. Another type of advance medical directive is a medical power of attorney that allows you to appoint someone else to make decisions about your medical treatment for you. "Do-not-resuscitate" or "do-not-attempt-resuscitation" orders (orders signed by a doctor instructing medical treatment providers not to attempt CPR in the event of cardiac arrest or respiratory arrest) are another type of advance medical directives.

The term "advance medical directive" is a generic term that usually refers to just one kind of directive - a living will, a medical power of attorney, or a "do-not-attempt-resuscitation" order. The Universal Advance Digital Directive (uADD)™ that you create using MyDirectives incorporates all of the elements of a living will and a medical power of attorney, but it does much more than that. The uADD also includes an expression of your preferences on CPR that is similar to the instructions included in DNR/DNAR orders, as well as organ donation and autopsy preferences. The uADD also includes a My Thoughts section that lets you describe non-medical requests about more personal aspects of your care and comfort, and contact information for your doctors, insurance providers, family and friends that medical treatment providers may need to contact if there is a medical emergency.  Finally, the uADD lets you to keep your answers simple or make them as detailed as you like by using open-ended text boxes or uploading audio and video files. All of these things combine to make the uADD a much higher quality document than a simple living will or any other standalone advance medical directive.

The most important difference between a uADD and an advance directive the process used to create it. First, MyDirectives is the only service that guides you through the process of creating a high-quality emergency, critical and advance care plan using a flexible process that lets you give detailed answers and accurately express your medical treatment goals, preferences and priorities. MyDirectives informs and educates you along the way, and we built logic into our system that will lower your chances of providing ambiguous or conflicting answers, but MyDirectives will never "lead" you or pressure you into choosing (or foregoing) particular medical treatments.  

The uADD is also different from an advance directive or a living will because it is created using a true digital healthcare platform. MyDirectives embraces modern technology and uses it to securely store your completed, signed uADD "in the cloud," and we work closely with healthcare providers, payers, and electronic medical record vendors to make your uADD available for retrieval 24 hours a day, seven days a week, anywhere in the world.

Most importantly, MyDirectives understands that emergency, critical and advance care planning isn't just about a legal form with signatures, it is about conversations.  Research shows that the only truly reliable strategy to ensure your medical treatment goals, preferences and priorities are considered if you ever suffer a health emergency and can't communicate is to discuss your values and wishes with your family, caregivers and healthcare providers ahead of time, before a crisis occurs. So, we make it easy for you to safely and securely share your uADD with whoever you want, we communicate with your chosen healthcare agents on your behalf, and we provide conversation starters and discussion guides to help facilitate those conversations.

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