Advance Directives

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Information provided by the VA San Diego Healthcare System
va.gov/vaforms/medical/pdf/vha-10-0137B-lg-print-fill.pdf

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Your Right to Make Health Care Decisions

What You Should Know About Advance Directives

As a VA patient, you have a say in the health care you receive. When you are ill, your provider should explain what treatments there are for your illness so that you can decide which one is best for you. However, if you were too ill to understand your treatment choices or to tell your provider what treatment you want:

  • Whom would you want to make decisions for you?
  • What type of health care would you want?
  • What health care would you not want?

Questions like these may be hard to think about, but they are important. That is why VA wants you to know about a legal form you can complete. It is called an Advance Directive.

What is an Advance Directive?

  • An Advance Directive (AD) is a legal form that helps your healthcare team and family members understand your wishes about health care.
  • It can help them decide about treatments if you are too ill to decide for yourself. For example, if you are unconscious or too weak to talk.
  • There are two types of Advance Directives: Durable Power of Attorney for Health Care and Living Will.

How do I complete an Advance Directive?

  • Fill out VA Form 10-0137, “VA Advance Directive: Living Will & Durable Power of Attorney for Health Care.” Or use any valid state Advance Directive form.
  • Talk to a health care professional at your local VA health care facility. This might be a social worker, your primary care provider, a spiritual adviser or attorney.
  • Your VA health care team can make your Advance Directive part of your electronic medical record.

Can I change my Advance Directive?

  • Yes. You may change or cancel your Advance Directive at any time.
  • You should review your Advance Directive when there is a change in your health status to make sure it is up to date.
  • If you change it, be sure to tell your health care team and have them put it in your medical record. Share your new directive with your family members and other loved ones.

Should I have an Advance Directive?

  • Yes. It’s a good idea to have one. An Advance Directive helps protect your right to make your own choices.
  • It helps make sure people respect your values and wishes if you can’t speak for yourself.
  • Your Advance Directive is used only when you are not able to make decisions yourself.

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Types of Advance Directives:

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Living Will

  • A Living Will is a legal form that states what kind of treatments you would or would not want if you become ill and cannot decide for yourself.
  • It can help your health care agent and/or your provider make decisions the way you want them to.
  • Writing down what kind of treatment you would or would not want can help make it easier for those who are asked to make decisions for you.
  • Talk with your family, your health care agent, and your provider about your wishes so they will not have to wonder what you want and if they are doing the right thing.
  • If you do not have a Living Will, decisions will be made for you based on what is known about you in general and about your values.
  • That is why it is important to discuss your wishes with your loved ones, your providers, and your health care team.

Durable Power of Attorney for Health Care (DPAHC)

  • This form lets you name the person you trust to make health care decisions for you if you cannot make them yourself—your “health care agent.”
  • He or she will have the legal right to make health care decisions for you. You can choose any adult to be your agent.
  • It’s best to choose someone you trust, who knows you well and who knows your values. You should make sure the person is willing to serve as your agent.
  • If you do not choose an agent, your provider will choose someone to make decisions for you in the following order: legal guardian (if you have one), spouse, adult child, parent, sibling, grandparent, grandchild, or a close friend.
  • Your health care team, or a court will make decisions for you based on VA policy if none of the above is available.

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Must my health care agent always follow my Living Will?

  • Most of the time, yes. Your health care agent should try to respect your wishes. But it can be hard to imagine future health and say just what treatment you would want at that time, so your agent may have to interpret your wishes.
  • In a VA Advance Directive, you can say if you want your agent to do just what your living will says, or if they may make the decision they think is best for you at that time, even if it is not what you said you would want.

What is a Mental Health or Psychiatric Advance Directive?

  • A Mental Health Advance Directive is a document that allows you to make your choices known about what mental health treatment you would want, in the event that your mental illness makes you unable to make decisions.
  • You are making decisions about treatment before the time that you will need it. This allows you to make more informed decisions and to make your wishes clearly known.
  • Many decisions may need to be made for you if you have a mental health crisis or are involuntarily committed . You may be unable to make treatment decisions. For example, the choice of hospital, types of treatment, and who should be notified are decisions that may be made for you.
  • At the time of crisis, you may not be able to make your wishes known, and you may end up with others making decisions that you would not make.
  • One way to be sure that your provider, relatives, and friends understand your feelings is to prepare a Mental Health Advance Directive before you become unable to make decisions.

Do I need to fill out a Durable Power of Attorney and a Living Will?

  • No. Although the VA form contains both it is up to you whether you complete the Durable Power of Attorney for Health Care, the Living Will or both.

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Resource for Advance Directives

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San Diego VA Health Care System
3350 La Jolla Village Dr
San Diego, CA 92161
Social Work Service (122)
Room 1494A
(858) 642-3671
(858) 642-3500
(858) 552-7496
Toll-free 1-800-331-VETS (8387) ext. 3671, 3500 or 7496
Fax: (858) 552-7455

Contact an OEF/OIF/OND Transition Case Manager or the San Diego VA Social Work Service for questions or assistance in preparing Advance Directives.