Most of us are accustomed to making our own health care decisions. But what happens when an illness or injury makes it impossible to make or communicate your wishes about your care? Advance Directives provide a way to communicate your desires about medical treatment to loved ones and health care providers in the event you cannot express your wishes yourself.
An Advance Directive is a legal document that provides instructions about your preferences for medical treatment. You can prepare an Advance Directive at any time, giving your family, caregivers, and healthcare professionals specific information about how you would--or would not--want to be treated.
Defining your preferences or naming a person to make decisions for you provides peace of mind to family members and loved ones and avoids confusion about your treatment. And it protects your best interests.
Illinois recognizes the Healthcare Power of Attorney, Living Will, and Mental Health Treatment Preference Declaration. Any competent adult can complete one or more of these documents. In addition, patients may want to talk with their healthcare provider about a Practitioner Order for Life Sustaining Treatment (POLST) and Do Not Resuscitate (DNR) Order. With limited exceptions, advance directives can be revoked at any time.
The health care power of attorney (POA) lets you choose someone to make healthcare decisions for you in the future if you are not able to make these decisions for yourself. The person you choose, called the agent, is to make the same decisions you would have made under the circumstances. If the agent is not able to determine what you would want in a specific situation, he or she must make a decision based on what is in your best interest. Unless specifically limited, the POA provides broad authority to the agent. Download a copy of the English version or Spanish version.
A living will lets your healthcare professionals know whether you want death-delaying procedures used if you have a terminal condition and are unable to state your wishes. A living will, unlike a healthcare power of attorney, applies only where the patient has a terminal condition. A terminal condition means an incurable and irreversible condition such that death is imminent and the application of any death delaying procedures serves only to prolong the dying process.
Death delaying procedures include ventilation, artificial kidney treatments, transfusions, and intravenous or tube feedings. Illinois law allows the withdrawal of artificially administered food and water, but only where death would result from the underlying illness. In addition, if a patient is pregnant and the health-care professional believes she could have a live birth, the living will cannot go into effect.
In a mental health treatment preference declaration, you may consent to or refuse electroconvulsive treatment (ECT), psychotropic medicine, or admission to a mental health facility in the event you have mental illness and are unable to make these decisions for yourself. You may also designate someone to make these decisions for you. This designated decision-maker is called the "attorney-in-fact" although the person need not be an attorney. During the time that your physicians have determined that you are unable to make decisions about mental health treatment, you may not revoke the declaration. Download a copy of the form in English or Spanish.
A POLST is a medical order that reflects the patient’s end-of-life treatment wishes and travels with the patient to various care settings. A POLST/DNR is completed by the practitioner only after the patient and practitioner confer about the patient’s wishes. Illinois uses a standard POLST/DNR form. The first part—the DNR-- addresses whether cardiopulmonary resuscitation (CPR) should be attempted if a patient’s heart and/or breathing stop. The form also allows a patient to express wishes related to emergency treatment and artificially administered nutrition.
Under Illinois law, a health care "surrogate" may be identified for patients when they cannot make health-care decisions for themselves and do not have an advance directive. A health care surrogate will be one of the following persons (in order of priority): guardian of the person, spouse, any adult child or children, either parent, any adult brother or sister, any adult grandchild or children, a close friend, or guardian of the estate. The surrogate will consent to or refuse medical treatment on behalf of the patient.
Now is a good time to start talking about Advance Directives. Talk with family, friends, and your healthcare professional about how you would want to be treated if you could not communicate decisions yourself. Talking before a crisis can help you and your loved ones prepare for difficult decisions that may arise in the future. If you already have an advance directive, take some time to review it. Your situation and feelings may have changed over time and you want your advance directive to reflect your current wishes.
Although you may choose to express your wishes in advance directives, they cannot be followed if no one knows they exist. It’s important to communicate your wishes in advance to someone you trust and to provide a copy of your advance directive to your healthcare provider.
You may contact the social service or pastoral care departments for more information about and assistance in preparing advance directives.
Additional information on advance directives is available at these websites: