The 4 Needs Advance Medical Directive®

The Farr Law Firm’s proprietary 4 Needs Advance Medical Directive® covers the following four essential needs that should be covered by every Advance Medical Directive but are missing from many:

  1. Medical Power of Attorney
  2. Long-term Care Directive® (proprietary to the Farr Law Firm)
  3. Near-Death Directive® (proprietary to the Farr Law Firm) and
  4. After-Death Directive® (proprietary to the Farr Law Firm)

Medical Power of Attorney

A Medical Power of Attorney (also called a Health Care Power of Attorney or Health Care Proxy), is part of an Advance Medical Directive. It authorizes another person (called your Medical Agent, Health Care Agent, or Health Care Proxy), to make decisions and give informed consent with respect to your medical care in the event that you are physically or mentally unable to make decisions for yourself, which typically must be certified by two physicians.

This document communicates your desires to your physicians and family members regarding all forms of medical treatment and may be used to instruct your physician to withhold specific life-prolonging procedures if at any time you are diagnosed as having a terminal condition and your physicians have determined that there can be no recovery from such condition and your death is imminent.

Long-Term Care Directive®

Federal law requires every nursing home to create a care plan. The care plan begins with a baseline assessment, which should occur within two weeks after a resident moves into the new facility, by a team from the nursing home (which may include a doctor, nurse, social worker, dietician, and physical, occupational, or recreational therapist). This team will use the information provided by the resident and the family about the resident’s medical and emotional needs to generate this baseline assessment, which then becomes the yardstick against which the caregivers can measure the resident’s progress.

The Farr Law Firm’s proprietary 4-Needs Advance Medical Directive® includes our proprietary Long-Term Care Directive®. The Long-Term Care Directive helps you organize, store, and disseminate information provided by you to better serve your future long-term care needs and to guide those who you will depend on for future care. The Long-Term Care Directive identifies your specific needs, desires, habits, and preferences, and guides your caregivers as to your wishes, should you find yourself in a nursing home or assisted living facility, unable to communicate, perhaps as the result of a stroke or other brain injury or dementia.

Here are a few examples of how this document functions daily (the examples below just scratch the surface, as this is a 15-page extremely detailed document):

Diet: Your Long-Term Care Directive can explain all of your dietary habits and preferences, such as whether you prefer coffee or tea in the morning, and how you take it (lightened, sweetened, etc.); whether you like juice with your breakfast and what type; whether you prefer a hot breakfast with eggs and breakfast meat or a cold breakfast with cereal or a muffin (and what type of cereal and what type of muffin).

Daily Activities: Your Long-Term Care Directive can detail what types of daily activities you enjoy. If you like to watch TV shows, what channels, what specific shows, what genres of shows? If you like to watch movies, what genres do you like? Any favorite actors or directors? If you like to listen to music or audiobooks, what types? Favorite authors?

Grooming and Hygiene: What type of mouthwash, toothbrush, toothpaste, soap, shampoo, conditioner, etc.?

Sleep Preferences: What type of pillows do you prefer (firm, soft, feather, foam), and how many pillows? Do you sleep on your back with pillows under your knees or on your side with a pillow between your knees? What type of sheeting and blanketing do you prefer? Do you like a fan blowing on you at night?

A Long-Term Care Directive should be created as part of your incapacity plan, Estate Plan, and Asset Protection Plan because the best person to create a care plan for you is you. This page gives an example of someone with and without a Long-Term Care Directive®.

Near-Death Directive™

The Near-Death Directive includes provisions allowing you to indicate your wishes concerning the use of artificial or extraordinary measures to prolong your life artificially in the event you have a terminal illness or injury. This part of the Advance Medical Directive is what used to be called a “Living Will,” and some attorneys in some states still use the term “Living Will.”

After-Death Directive™

The After-Death Directive allows you to indicate your wishes with regard to organ donation, disposition of bodily remains, funeral arrangements, what you’d like in your obituary and on your grave marker, etc.

In order to be easily accessible when needed, your Advance Medical Directive should be registered with an electronic archive service (Docubank) that can immediately fax the document to any desired destination. This firm will provide such registration service to you at no charge, unless you would prefer that the document not be registered.

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