Advance Directives & Living Wills

Estate planning isn’t just about what happens to your assets after you die. It’s also about ensuring your wishes are respected and your loved ones have clear guidance if you become unable to make decisions for yourself. Advance directives and living wills address these critical concerns, providing instructions for your medical care and designating who can make decisions on your behalf during times of incapacity.

At the Law Office of Michael Paul, PLLC, we help individuals and families throughout Rolesville, Wake Forest, and surrounding communities create comprehensive advance directive documents. These planning tools offer peace of mind, knowing that your values and preferences will guide your care, even when you cannot speak for yourself.

Why Advance Directives Matter

Medical emergencies and incapacitating illnesses often arrive without warning. A sudden accident, stroke, or unexpected diagnosis can leave you unable to communicate your treatment preferences. Without advance directives in place, your family members may face agonizing decisions about your care without knowing what you would want.

Even more challenging, hospitals and medical providers may be legally unable to discuss your condition or treatment options with family members if you haven’t designated someone to make medical decisions on your behalf. This can leave your loved ones feeling helpless and frustrated during an already stressful time.

Advance directives solve these problems by documenting your wishes in advance and giving someone you trust the legal authority to act on your behalf. These documents spare your family the burden of guessing what you would want and provide clear direction to medical professionals treating you.

Understanding the Different Documents

The term “advance directives” encompasses several related documents, each serving a specific purpose in your incapacity planning.

A living will, sometimes called an advance directive for a natural death, addresses your preferences for end-of-life medical care. This document typically becomes effective only when you have a terminal condition or are in a persistent vegetative state with no reasonable hope of recovery. It allows you to state whether you want life-sustaining treatments continued or withdrawn in these circumstances.

Life-sustaining treatments might include mechanical ventilation, tube feeding, cardiopulmonary resuscitation, dialysis, and antibiotics. Your living will expresses your values and preferences regarding these interventions when recovery is no longer possible. Some people prefer that all measures be taken to extend life as long as possible, while others prioritize comfort and dignity over prolonging the dying process.

A health care power of attorney, also called a health care proxy or medical power of attorney, designates someone to make medical decisions on your behalf if you become incapacitated. Unlike a living will, which only addresses end-of-life situations, a health care power of attorney applies to any medical situation where you cannot make or communicate decisions.

Your health care agent can consent to or refuse treatments, select doctors and facilities, access your medical records, and make decisions about your care based on your known wishes and values. This person acts as your voice when you cannot speak for yourself.

A HIPAA authorization allows designated individuals to access your medical information. Without this authorization, strict privacy laws may prevent even close family members from obtaining details about your condition or treatment. Including HIPAA language in your advance directives ensures the people who need information to make decisions or support you can obtain it.

Choosing Your Health Care Agent

Selecting a health care agent is one of the most important decisions in your advance planning. This person should be someone you trust completely, who understands your values, and who will respect your wishes even if they differ from what the agent would choose for themselves.

Your health care agent should be willing and able to ask difficult questions, advocate for you with medical professionals, and make tough decisions under stressful circumstances. While many people choose a spouse or adult child, the best choice is someone who combines emotional resilience with a clear understanding of your preferences.

Consider whether the person you’re considering lives nearby or could travel quickly in an emergency. Think about their relationship with other family members and whether they can handle potential disagreements or pressure from relatives who might have different opinions about your care.

It’s also wise to name an alternate agent in case your first choice is unavailable or unable to serve when needed. Life circumstances change, and having a backup ensures someone you trust can always step in.

What to Include in Your Directives

Effective advance directives go beyond checking boxes on a form. They reflect your personal values, beliefs, and preferences in ways that provide meaningful guidance to your health care agent and medical team.

You might address your feelings about pain management and comfort care. Some people prioritize staying alert and mentally clear even if it means experiencing more discomfort, while others prefer to prioritize pain relief. Your directives can express these preferences.

Consider your views on various medical interventions. Would you want to be resuscitated if your heart stopped? Would you want a feeding tube if you could no longer swallow? Would you want to remain on a ventilator if you couldn’t breathe on your own? There are no right or wrong answers to these questions, only your personal choices.

You might also address organ and tissue donation, autopsy preferences, and your wishes regarding spiritual or religious support during medical treatment. The more specific and thoughtful your directives, the better they serve you and your loved ones.

When Advance Directives Take Effect

Your advance directives remain dormant as long as you can make and communicate your own medical decisions. You retain complete control over your health care, and your health care agent has no authority to override your choices.

These documents only become effective when your physician determines you lack the capacity to make informed medical decisions. This might occur due to unconsciousness, severe dementia, mental illness, or any other condition that prevents you from understanding and communicating about treatment options.

Once activated, your health care agent steps into your role, consulting with doctors, reviewing treatment options, and making decisions based on your documented wishes and known values. If you regain capacity, you immediately resume control over your medical decisions.

Updating Your Advance Directives

Your advance directives should evolve as your life circumstances and health status change. After a serious diagnosis, your perspective on treatment might shift. Changes in your family situation, such as divorce, death of your designated agent, or strained relationships, may require updates to your documents.

Even without significant life changes, reviewing your advance directives every few years ensures they still reflect your current wishes. Medical technology advances, treatment options expand, and your own views may mature over time.

North Carolina law allows you to revoke or modify your advance directives at any time, as long as you have the capacity to do so. If you create new directives, be sure to destroy old versions and inform your health care agent and family members about the updates.

Discussing Your Wishes with Loved Ones

Creating written advance directives is important, but equally valuable is discussing your wishes with your health care agent and close family members. These conversations help ensure everyone understands your values and the reasoning behind your documented choices.

Talk with your health care agent about specific scenarios and what you would want in those situations. Discuss your priorities, fears, and hopes. Share the reasoning behind your decisions so your agent can apply your values to unexpected situations not specifically addressed in your written directives.

While these conversations can feel uncomfortable, they’re far easier to have when everyone is healthy than during a medical crisis. Your openness now can prevent confusion, conflict, and guilt later.

How We Help You Plan

We approach advance directive planning as a thoughtful, personalized process. During our consultation, we’ll discuss your values, concerns, and goals for your medical care. We’ll explain the different types of advance directives and help you understand how each document protects you.

We’ll guide you through the decisions involved in creating your directives, ensuring you understand the implications of your choices. We prepare documents tailored to your specific wishes, using clear language that complies with North Carolina legal requirements.

We also help you think through the selection of your health care agent and discuss how to have productive conversations with your agent and family members about your wishes. Our goal is to ensure you feel confident that your preferences will be respected and your loved ones will have the guidance they need.

Making These Important Decisions

Advance directives are gifts you give to yourself and your loved ones. They ensure your voice remains heard even when you cannot speak, and they provide clarity and direction during what might otherwise be chaotic and emotionally overwhelming situations.

If you’re ready to create advance directives or need to update existing documents, we’re here to help. Contact the Law Office of Michael Paul, PLLC at 919-951-7955 or email michael@michaelpaullaw.com to schedule a consultation. Let’s work together to ensure your medical care wishes are documented and your family has the guidance they’ll need if the unexpected occurs.