Advance directives are an important part of planning for the future. Few of us want to think about what would happen if we or a loved one were in a devastating accident or incapacitated by advanced illness. Yet it’s recommended that everyone over the age of 18 have a written plan in the event of a sudden illness or injury. Every state has different rules around advance directives, so be sure to check what documents are recognized in your state. This page includes information about New York State advance directive forms and end-of-life documents.
There are many types of advance directive documents. Here are four common ones:
Health Care Proxy is the written document that designates a person as your health care agent when a doctor determines that you have lost capacity to make decisions for yourself. It also allows written statements about desired medical treatment decisions in advance. It is a good idea for everyone over the age of 18 to have one. Health care proxies can be designated for temporary situations (i.e., surgeries or sudden illness) or for permanent situations (i.e., you are in a coma or if you develop dementia or Alzheimer’s). There is a simple form you can fill out yourself: NYS Advance Directive Form: Health Care Proxy.
A Living Will is a written document that allows you to state your wishes for different medical treatments in advance. Unlike a health care proxy, it does not designate someone you trust to make treatment decisions on your behalf, but can serve as evidence of your wishes as long as the directives are stated clearly and should be updated regularly.¹ You should discuss your medical care options with your doctor including the pros and cons of prolonged medical treatment. This will help you make a decision that is right for you. Examples of medical treatments in a living will include mechanical respiration (machines that breathe for you), tube feeding, hydration/fluids and pain relief/comfort care. You can have both a health care proxy and a living will. The NYS Department of Health website states that New York State does not have a standard living will form. But, New York State does recognize living wills as valid if they provide “clear and convincing evidence” of the person’s wishes.
The DNR—Do Not Resuscitate is a medical order issued by a doctor, at your request. The DNR tells medical staff not to provide CPR (chest compressions) if your heart stops. A DNR order does not mean the withholding of all medical care, only CPR. DNR instructions can also be made known in a health care proxy or a living will. It is very important to discuss DNR with your doctor. Download a NY DNR form.
The DNI—Do Not Intubate is a medical order issued by a doctor, at your request. It specifies whether a breathing tube can be inserted in your throat. DNI instructions can also be made known in a health care proxy or a living will. Talk with your doctor about when intubation might be used and to see if it is something you would want. A NYS advance directive form provided by the New York State Department of Health can be used for both DNI and DNR orders: Medical Orders for Life-Sustaining Treatment (MOLST).
¹A living will is not formally recognized under New York law, but some courts have allowed a living will to serve as evidence of a patient’s wishes if the directives were clear.
Are you caring for a family member or friend? Sign up for Caring Delivered, VNSNY’s free newsletter just for caregivers, and get the information you need.