DEAR MAYO CLINIC: Every time I go to my doctor I’m asked if I have an advance directive. What exactly is it, and at what age should I start thinking about this?
ANSWER: An advance directive is part of the advance care planning process. In this process, you look at your goals and values, and express your preferences for certain types of medical care based on these goals and values. It’s a process you should work through with the people you trust: your family, friends and medical provider. When you are ready to put your thoughts and preferences on paper, the actual form you fill out is an advance directive. It’s a legal document that goes into effect only if you are incapacitated and unable to speak for yourself.
At some point, nearly three-quarters of all people will be in a medical situation where they cannot communicate their wishes to their health care providers. This can happen to young people, as well as those who are older. Accidents, devastating events and unforeseen medical situations affect people of all ages. Having an advance directive makes clear to your health care team what you do and do not want in those situations.
Although they are extremely helpful to have in many medical circumstances, about two-thirds of older adults in the United States don’t have an advance directive. Many people don’t create an advance directive because they assume their spouses or children already know what they want. But it’s very difficult for your loved ones to clearly understand and follow through on your preferences if you haven’t specifically talked about them.
So, the first step in creating an advance directive is to take time to think about your health goals, your health values and the types of treatment you would or would not want in a serious or life-threatening medical situation. Then have a focused conversation about those topics with the people closest to you, such as your spouse, adult children, other family members, close friends, or members of your faith community. Talk to your primary care provider, too. He or she can help answer questions, identify other issues to think about and clarify any areas that are unclear.