YOUR WISHES DOCUMENTED

Advance Directives

HEALTHCARE PROXY FORM

The New York Health Care Proxy Law allows you to appoint someone you trust to make health care decisions for you if you are unable to communicate or lose the ability to make decisions yourself. It is easy to complete the simple two-page health care proxy form. A lawyer is not needed and it does not have to be notarized; you just must have your signature witnessed by two people who are at least 18 years old, neither of whom is the health care agent you appointed. [wpdm_package id='1371']

DO NOT RESUSCITATE (DNR) ORDER

A DNR is appropriate for elderly or very ill people who do not want to be revived if they stop breathing or if their heart stops beating. If you are at home rather than in a nursing home or hospital, you must have an official “Out of Hospital” DNR form, and it must be signed by a doctor. [wpdm_package id='1924']

LIVING WILL

A living will lists the types of health care treatments you would or would not want under various circumstances. There is no official New York State form for a living will; the one provided here is just an example that can be changed to be consistent with your wishes. It is more important to name a health care agent, using the health care proxy form, than to create a living will; the living will is optional. [wpdm_package id='1926']

DEMENTIA DIRECTIVE

How much medical care would you want if you had Alzheimer’s disease or another type of dementia? This form is free to download and use as an Alzheimer’s-specific living will. Fill it out now, share it with your loved ones, then give a copy of it to your doctor. Provide guidance now. Feel better that you’ll get the medical care that you would want. Help your loved ones if they are faced with making difficult decisions on your behalf. [wpdm_package id='1925']

MOLST FORM

The Medical Orders for Life-Sustaining Treatment (MOLST) form is similar to a living will. It allows you to state your wishes about certain healthcare treatments, including CPR, intubation, artificial nutrition and hydration, mechanical ventilation and antibiotics. It must be signed by a physician and may be more likely to be honored than a living will because it is a medical order. Some doctors are only willing to sign a MOLST form if you could be reasonably expected to die within a year or you live in a long-term care facility. However, the MOLST form may also be appropriate if you do not have a person to appoint as your health care agent. If you no longer have decision-making capacity, the MOLST form can be completed by your health care agent or public health law surrogate. [wpdm_package id='1927']

POLST FORM

The POLST: Physician Orders for Life-Sustaining Treatment form tells emergency personnel what treatments you would want in the event of a medical emergency. The current standard of care during an emergency is for medical professionals to do everything possible to attempt to save a life. Not everyone wants this treatment, and the POLST provides the option for you to: (1) confirm this is the treatment you want or (2) to state what level of treatment you do want.e an official “Out of Hospital” DNR form, and it must be signed by a doctor. [wpdm_package id='1928']