Advance Directives
Communicate Your Healthcare and End-of-Life Wishes
Most people do not want to burden their family with tough decisions. Yet few have communicated their end-of-life wishes to their loved ones. It’s a tough conversation to have, but it’s also vitally important.
Learn more about your options and how to get that conversation started.
Advance Directives
While making medical care decisions is not always simple, it is very important to ensure that your healthcare decisions and wishes are clearly noted and communicated. It is your right to participate and plan for your care. Exeter Hospital and its affiliates want to ensure that all adults in our community who are able to make decisions have the information and opportunity they need to communicate and document their decisions.
We urge our community members to make future healthcare decisions known to family, friends and providers. Share your wishes and complete your Advance Directives because YOUR DECISIONS MATTER.
If you need help with advance care planning and how to complete your New Hampshire Advance Directive, we invite you to watch “Having the Conversation: Talking About and Planning Your Wishes for Future Healthcare,” a video in 2 parts presented by our HealthReach Community Education department. Both parts walk you through the process as well as helpful tools and resources.
- Part 1: Describes how important it is to think about your values and goals and how they can help you with your wishes for end-of-life care, and then talk about your wishes with family members, your healthcare team, and other important people in your life.
- Part 2: Describes how to complete the documents for your New Hampshire advance directive.
Importance of Advance Directives
Important points to know about Advance Directives include:
- Your advance directive should reflect your wishes.
- Lawyers are not needed.
- Not all documents are legally valid in every state.
- In New Hampshire, the signatures of either two witnesses or a notary are required.
- Your Advance Directive does not expire, but can be re-created or updated at anytime.
Once you complete your Advance Directives, you will feel secure in knowing:
- You have appointed a Health Care Agent to make care decisions for you when you can’t make them for yourself.
- Your medical care wishes will be known.
- You have identified and communicated the comfort care measure you would like to receive.
- You have communicated your emotional and spiritual needs.
Documenting Your Decisions
- Documents who would make medical decisions for you
- Your Durable Power of Attorney for Health Care is authorized to speak ONLY if you can’t
- May also be called a:
- Health Care Agent or Health Care Proxy
- Health Care Power of Attorney
Your Health Care Agent
- Can be anyone over the age of 18.
- Can be a family member, loved one or close friend
- Cannot be your personal physician
- Is someone who:
- You trust
- Knows you well
- Will advocate on your behalf
- Will honor your wishes
- States what you want and do not want for life sustaining medical treatments at the end of life or if you are permanently unconscious
- May also be called:
- Directive to physicians
- Healthcare declaration
- Medical directive
Frequently Asked Questions
It involves:
- Learning about available life sustaining treatment options
- Thinking about your values
- Talking about your decisions
- Documenting your wishes
- Designating a decision maker on your behalf if and when the need were to arise
Having advance care plans in place can help both you and your loved ones in the following ways:
- When you are unable to speak for yourself
- When sudden illness or accidents happen
- By leaving a guide for others to follow
- By giving peace of mind to loved ones
- New Hampshire’s new “Surrogate Decision-Maker Law” took effect on January 1, 2015. The new law created an amendment to the State’s Advance Directives statute by creating a list of family members and friends, in order of priority, who may make health care decisions in certain situations for patients who don’t have a written Advance Directive.
- Under the amended law, if a physician or nurse practitioner determines a patient is temporarily or permanently incapacitated (unable to understand, reason about and make a choice regarding the risks and benefits of a healthcare decision) but the patient has not previously authorized a health care agent through an Advance Directive, an adult relative or friend may be identified to make health care decisions on the patient’s behalf (act as a surrogate) for up to 180 days, in the following order of priority:
- The patient’s spouse, civil union partner, or common law spouse. (Unless there is a divorce proceeding, separation agreement, or restraining order limiting that person’s access to the patient)
- Any adult son or daughter of the patient.
- Either parent of the patient.
- Any adult brother or sister of the patient.
- Any adult grandchild of the patient.
- Any grandparent of the patient.
- Any adult aunt, uncle, niece, or nephew of the patient.
- A close adult friend of the patient. (As defined by the law)
- The agent with financial power of attorney or an appointed conservator.
- The guardian of the patient’s estate.
- The “Surrogate Decision-Maker Law” is not meant to replace a written Advance Directive. The surrogate’s authority is temporary, for up to 180 days. There are other limitations as well. More information is available at the New Hampshire Foundation for Healthy Communities.
- Completing a written Advance Directive is still the best way to make sure your health care decisions will be honored if you cannot speak for yourself.
- Learn about life-sustaining treatments.
- Reflect upon your values.
- Decide what you want and do not want.
- Talk to others.
- Discussion is a valuable opportunity to reflect on what’s important with loved ones.
- Discussion needs to happen before a crisis.
- Discussion can provide comfort to your loved ones.
- Discussion is up to YOU to initiate.
- What do you want and not want at the end of life?
- Who should speak for you?
- What are your concerns?
- What gives your life the most meaning?
- What one thing do you want to be sure your doctors, family and friends know about your wishes?
