What Are the Three Different Types of Advance Directives?

Serious illness or accident can strike at any time, leaving you unable to make your own medical decisions. Who will speak for you when you can’t? How will doctors know what treatments you want or don’t?

Advance directives empower you to take control and share your voice even when illness silences you. But if you’re puzzled over the different types available, you’re not alone.

As elder law attorneys helping Minnesota families plan for healthcare crises, we’re here to bring clarity amid the confusion. Read on as we break down the key legal documents you can use to protect your care wishes and priorities.

Health Care Directives

In Minnesota, the primary advance directive is called a health care directive. This legal document allows you to:

• Name a healthcare agent (or proxy) who can make medical decisions on your behalf if you become incapacitated.
• Specify instructions for the types of medical treatments you want and don’t want in end-of-life situations or permanent unconsciousness.

Your agent should be a trusted person who understands your values and can remain objective when faced with difficult choices about medical intervention. Always name alternative agents in case your first choice becomes unavailable.

The health care directive provides the opportunity to describe in detail your preferences regarding life-sustaining treatments like CPR, breathing machines, feeding tubes, dialysis, pain medication, and more.

Since 2018, in Minnesota it is important to include language authorizing your agent to make decisions about “intrusive mental health treatments” that may be critical to your comfort and well-being. 

You can specify which situations would make your life intolerable, like advanced dementia or permanent coma. These instructions guide your agent and doctors in deciding whether to continue extensive life-prolonging measures if you can’t make decisions yourself.

Physician Orders for Life-Sustaining Treatment (POLST)

A Physician Order for Life-Sustaining Treatment (POLST) is a medical order that documents your wishes for end-of-life care. It is intended for seriously ill or frail patients.

The POLST is based on conversations between you and your physician where you communicate your treatment preferences. Your doctor then completes the standardized POLST form accordingly, outlining your desires regarding resuscitation, intubation, feeding tubes, and other interventions.

Unlike an advance directive, the POLST is a medical order signed by your treating physician. It is followed by emergency personnel, hospital staff, and other healthcare providers when you cannot convey your wishes yourself.

Do Not Resuscitate Orders

A Do Not Resuscitate Order (DNR) is a type of POLST that only covers respiratory resuscitation. It tells emergency medical personnel not to perform CPR if your heart or breathing stops.

With a DNR, EMTs and first responders will allow natural death and provide comfort care instead of resuscitation efforts. 

How to Complete Your Advance Directive

Now that you understand the different types of advance directives, here are key steps for completing yours:

1. Familiarize yourself with Minnesota law on health care directive requirements
2. Work with an estate planning attorney to create a customized Health Care Directive aligned with your values
3. Name primary and alternate agents who meet requirements and agree to serve
4. Describe your preferences for medical treatments and end-of-life care
5. Execute the document formally before a notary public or two adult witnesses who are not named agents.
6. If you want a DNR or POLST , work with your physician to understand the implications, and to complete the DNR or obtain the POLST. 
7. Distribute copies to your agents, family, and healthcare providers
8. Keep the original in a secure but accessible place for your agents
9. Review periodically and update documents if your wishes change

The importance of advance care planning hits home when illness strikes unexpectedly. While difficult to discuss, specifying your wishes now brings comfort and control when you need it most.

Equip your loved ones to honor your care preferences by completing your health care directive and other applicable advance directives. If you need guidance creating customized documents for your unique needs, our attorneys are here to help. Contact us today to get started.