Five times you should review and update your healthcare directive

If you have an advanced healthcare directive that outlines what types of medical care you do and do not wish to receive and who should make medical decisions for you if you cannot make them for yourself, then you’re better prepared than nearly 2/3 of Americans. But getting your wishes down on paper in the form of an advanced healthcare directive or living will and a durable power of attorney for healthcare is just the first step. It’s equally important to occasionally review and revise your healthcare directive to make sure it’s still in line with your goals, beliefs, and wishes.

There are five life events that should trigger a review of your healthcare directive:

1. You enter a new decade of your life.
2. You get separated, divorced, or married.
3. Your spouse or partner dies or is no longer competent to make these decisions on your behalf due to a medical problem such as dementia or a psychological issue.
4. You are diagnosed with a serious illness such as cancer, chronic pulmonary obstructive disorder (COPD), or heart failure.
5. Your health declines and makes it significantly more difficult for you to live independently or you move into an assisted living facility.

When you review the documents, think about whether you want to keep the same person as your healthcare proxy (the person who would make medical decisions for you if you cannot make them yourself). For example, your children may now be adults and capable of taking on the role. Also think about the types of medical interventions you’re willing to undergo, including the use of a feeding tube or ventilator, CPR or defibrillation if your heart stops, and the use of pain medication if you are dying.

If you make changes to your directives and other documents, you should contact everyone who has a copy of the documents (physicians, family members or friends, attorneys), provide them with the new documents, and instruct them to destroy the old documents to eliminate the risk of confusion.

It’s also wise to review your directives if you move to a new state or divide your time between homes in different states. While most states recognize valid healthcare directives from other states, it’s still advisable to share the document with your physician and attorney in your new home state or in the states where you spend a significant portion of the year to make sure the documents are valid there.

When you travel, especially if you’re living with a chronic health condition or have been diagnosed with a serious illness, carry either a copy of the documents or a card that alerts emergency responders and physicians to the fact that you have a healthcare directive and where the documents can be found. If you have an electronic medical record, you may also want to include these documents in your medical record so they’re available to any physician who treats you in an emergency.