Advance Directives & Living Wills
All adult patients should understand advance directives. Federal law requires certain facilities, including hospitals, nursing homes, and home health agencies provide written information about an individual's rights under state law to make decisions concerning medical care, including the right to accept or refuse medical or surgical treatment, and the right to formulate advance directives.
Those facilities must document in your current medical record whether you have executed an advance directive.
Every patient in a Lee Health facility should be asked whether they have written an advance directive.
Advance directives are not required to receive care in Lee Health, but they are provided to you to be able to document your wishes about treatment.
What is an Advance Directive?
An advance directive is a set of instructions you have prepared about your medical care. They may describe what treatment you want and serve to convey your wishes to the medical team if you are not able to give directions yourself.
Who can be a witness to a Living Will?
Generally, any adult can be a witness, but a spouse or blood relative can be only ONE of the witnesses. The second witness should be someone who is not related to you. The person you have named as your surrogate should not be one of the witnesses.
What is a Living Will?
A living will contains specific instructions about whether you want life-prolonging procedures in the event you have a terminal condition, an end-stage condition, or are in a persistent vegetative state.
What is a Designation of Health Care Surrogate (DHCS)?
A DHCS is a document you sign appointing a surrogate you trust to make health care decisions for you if you are temporarily or permanently unable to make decisions. It is important you let the surrogate know your wishes about your medical care and treatment, so that your surrogate will make the decisions.
When does my Living Will or other advance directive actually go into effect?
Your physician, after evaluating your condition, will call in another physician for a second opinion. If both determine that you have a terminal condition, an end-stage condition, or a persistent vegetative state, your living will goes into effect. If you have designated a surrogate and it is determined by your physician that you do not have the or ability to make your own decisions, then your surrogate will be asked to provide consent for you.
What if you have not made an Advance Directive or cannot sign my name on a Living Will?
You can give verbal instructions to your physician and family. However, it is more helpful for you to put your wishes in writing.
What if you change my mind and want to delete all or part of my Living Will? Your advance directive can be revoked at any time by doing any of the following:
- signing a written statement saying that you revoke it
- physically tearing up the directive or have someone else tear it up in your presence
- orally expressing that you revoke it;
- executing another advance directive that is different than the previous one
The most important thing to remember is to tell your doctor, family, or friends what you want.
Can my life insurance company cancel my life insurance for saying I want life support withheld or withdrawn?
No. Florida law states that no policy of life insurance will be invalidated by you making these choices. You cannot be required to make an advance directive as a condition for getting insurance or being admitted to a hospital.
I signed a Living Will in another state. Is it valid here?
Florida will recognize an advance directive executed in another state provided that it meets that state's or Florida's state requirements.
Where should I keep my Advance Directive?
It is important that your advance directive live in an accessible place and that your surrogate, family, and physician all have a copy of it. You should also bring a copy with you each time you are admitted to the hospital, or ask someone to bring it for you.
Where can I get an Advance Directive?
You can get a form for free by clicking here. For a version in Creole, click here. For a version in Spanish, click here. There are other versions of living wills available. This one is the example provided in Florida Statutes. You may use another version of a living will, but it may be advisable to make sure that it meets Florida Law requirements.
Do I need a lawyer to make a Living Will or designate a health care surrogate?
No. You can execute a living will or health care surrogate designation without a lawyer. However, if you need to prepare documents related to financial decisions, such as a Durable Power of Attorney, you should ask for an attorney’s help.
If you have more questions and would like more assistance, please feel free to call us at:
Medical Social Work
Department of Care Management
Older Adult Services
HealthPark Care and Rehabilitation Center Social Services