DNR, health-care proxy, living will.

What are those?

What do they mean?

Do I need them?

Well, those are all referred to as advance directive documents. Those are documents that are used to provide direction to others with regard to a person’s health-care wishes.

Those documents are created before a medical crisis or event. They are used by health-care personnel in the planning of a person’s care if and when that person becomes incapable of making his or her own health-care decisions.

Those documents are extremely valuable when dealing with situations where there may be questions regarding what this person would choose, should he have been able to choose for himself.

In New York state, the health-care proxy and do not resuscitate, or DNR, order are the two legally recognized advance directives.

Living wills are also helpful in instances where health-care personnel and families are looking for guidance regarding planning for a patient’s health care.

A living will is an instruction document that is designed to ensure a person receives the care they desire when in a terminal condition. A living will can also supplement a health-care proxy.

Doctors find living wills helpful when advising family members regarding the care to be provided to a patient.

A DNR order can be written by a doctor for any patient who requests one. It can also be written for a patient at the request of a health-care agent or other relative if the patient has not completed a health-care proxy.

The doctor would discuss the patient’s situation with the person requesting the DNR order before finalizing a decision to write such an order.

A DNR order generally means that if a person’s heartbeat and breathing were to stop, health-care personnel would not attempt to restore the person’s breathing and heartbeat through the use of cardiopulmonary resuscitation. A DNR order can be in effect in a hospital and at home if the person so wishes.

The health-care proxy was created in 1990 as the document wherein a person can designate one or two individuals, called health-care agents, to make health-care decisions for him in the event that he becomes temporarily or permanently unable to do so for himself. This replaces a regular power of attorney as far as health-care matters go. (The power of attorney form can now only be used for financial transactions in New York.) In addition to designating health-care agents, a person can use the health-care proxy document to record his specific wishes for his health care.

Here are some things to keep in mind when creating a health-care proxy. Before completing a health-care proxy form, you may want to discuss your wishes and views with your doctor. He or she is likely to be the one caring for you when your instructions are needed. Furthermore, your doctor can answer any questions you may have about the options for various treatments.

It is also important that you discuss your desires with family and friends, and especially those people who are agreeing to become your health-care agents. They can often help to clarify your directives for your doctor on the basis of specific discussions you have had. Another benefit of discussion with family members is that this can reduce confusion and challenges to your directives at a time when it is crucial to know what you would want for your care.

Choosing the right people to act as your agents is very important. The agents you choose should know your wishes and agree to follow those wishes. One of the issues that your agents need to be familiar with is your wish regarding artificial feeding and nutrition (feeding tubes). The clearer you can be about all of your wishes, the easier it is for your agents to ensure you receive the care you desire.

So, as a senior, do you need these documents?

The answer is:

Every adult should have a health-care proxy, no matter his or her age or state of health. A health-care proxy can easily be completed at home, at your local hospital or at your doctor’s office.

A living will document is optional.

A DNR document is generally used only in those situations where attempting to resuscitate a person would be harmful to the person or felt to be futile.

The most important part of all of this is open dialogue with your doctor, family and health-care agents so that they are familiar with your thoughts and feelings and will be prepared to act in accord with your wishes should they be asked to do so. Although not easy discussions, they are necessary and can help ensure that you receive the health care you desire.

Wendy L. Fisher, a registered nurse with a Bachelor of Science degree, is patient education coordinator at A.O. Fox Memorial Hospital in Oneonta.