What Are Advance Directives?

Have you ever gone to the hospital and had to fill out a form that asked if you have advance directives? You may have thought to yourself: what are these? Advance directives are legal documents that allow you to plan ahead for important health care and financial decisions in case you become incapacitated or unable to make those decisions yourself. Put another way, these are your written instructions and appointments of trusted persons for the future.

Think of advance directives as a safety net: they speak for you when you can’t speak. They are helpful to doctors and relieve your family from guesswork in a crisis. Common types of advance directives include:

• Medical Power of Attorney: Appoints an agent to make medical decisions for you if you’re unable.
  
• Living Will: States your wishes for end-of-life care and life support if you are terminally ill or in a persistent vegetative state.
  
• Financial Power of Attorney: Appoints an agent to manage your finances and property if you become incapacitated.

Why Do Advance Directives Matter?

Advance directives matter because life is unpredictable. No one likes thinking about worst-case scenarios, but a sudden illness or accident could leave you unable to voice your wishes. Having these documents in place provides peace of mind for you and your loved ones.  Here’s why they’re so important:

• Avoiding Court and Conflict: If you don’t have advance directives and you become incapacitated, your family might have to go to court to get authority to make decisions. Court processes can be stressful, time-consuming, and costly. Advance directives spare your loved ones from that burden.
  
• Ensuring Your Wishes Are Followed: With written instructions, doctors know what treatments you do or don’t want at the end of your life. Without that, doctors may choose a plan that you would not have wanted. Likewise, a healthcare agent you trust can speak up for what you would decide.
  
• Reducing Family Guilt and Disagreements: These documents take tough choices off your family’s shoulders. For example, a living will can clearly state your preferences about life support, so your kids or spouse aren’t left wondering what to do or fighting with each other over what decision to make. It can prevent family disagreements because everyone has clear guidance from you.
  
• Continuity of Financial Matters: A financial power of attorney ensures that bills get paid and finances managed if you’re incapacitated. Without it, even your spouse or adult children may struggle to access accounts or pay bills on your behalf, potentially causing lapses in care or financial harm.

Medical Power of Attorney

A Medical Power of Attorney is a document where you name someone to make health care decisions for you if you can’t make them yourself. In Colorado, this person is often called your health care agent. This is not just for end-of-life situations – your agent can make any medical decision you could have made, from treatment options to choosing doctors or consenting to surgery.

Depending on how you set it up, here are key points about a Colorado Medical POA:

• Scope of Authority: Your health care agent has broad authority to talk with doctors, access your medical records, and decide on treatments on your behalf. They’re essentially stepping into your shoes for medical matters. For example, your agent could decide whether to proceed with a certain surgery, or choose among treatment alternatives, based on what they believe your wishes and best interests are.
  
• Not Just End-of-Life: Unlike a living will, which only covers specific end-of-life scenarios, a medical POA covers any situation where you can’t make health decisions – whether it’s a temporary coma, dementia, or any condition leaving you unable to consent.
  
• Choosing an Agent: Pick someone you trust deeply. It should be a person who understands your values and is willing to speak up firmly for your wishes. Common choices are a spouse, adult child, or close friend. Make sure to talk with your chosen agent so they’re aware of your priorities – communication is key.
  
• Successor Agents: In the document, you can (and should) also name backup agents in case your first choice is unavailable. For example, you might name your spouse as primary agent and an adult child as the alternate. That way, there’s always someone empowered to act for you. 

Living Will

A Living Will is an advance directive that addresses end-of-life medical care. In simple terms, it answers the hard question: “If I am dying and unable to speak, do I want my life prolonged by machines or other treatments?” This document allows you to spell out your wishes regarding life-sustaining procedures if you are terminally ill or in a persistent vegetative state, and unable to communicate or make decisions.

Key features of a living will include:

• When it Applies: A living will only comes into play in very specific circumstances. Under Colorado law, it kicks in if two physicians certify in writing that you have a terminal condition (an incurable illness or injury that will result in death) or are in a persistent vegetative state, and that you are unable to make decisions. In a terminal condition, the doctors must also agree that death would occur relatively soon “with or without intervention.”
  
• Life-Sustaining Procedures: You use the living will to declare whether you want life-sustaining procedures withheld or withdrawn in those circumstances. “Life-sustaining procedure” in Colorado means any medical intervention that only prolongs the dying process without curing the condition.
  
• Artificial Nutrition and Hydration: The living will lets you specify your wishes about feeding tubes or IV hydration if that is the only thing keeping you alive. Colorado’s form allows you to initial whether you do or do not want artificial nutrition and hydration continued and even lets you specify a time limit if you wish.
  
• Organ Donation: You may include in your living will whether you want to be an organ donor. People can combine these end-of-life instructions with their donation wishes so everything is in one place.
  

As with most estate planning documents, you can revoke or change your living will at any time, as long as you’re mentally capable. If you do make updates, be sure to tell your doctor and give copies to anyone who had older versions, so they know your current wishes. In practice, it’s wise to review your living will periodically to ensure it still reflects your wishes.

Financial Power of Attorney

A Financial Power of Attorney is the sibling document to the medical POA. Instead of health decisions, this one deals with money and property decisions. In it, you name an agent to handle financial matters on your behalf. This can include paying your bills, managing bank accounts, handling insurance or government benefits, filing taxes, and even real estate or investment transactions on your behalf. Essentially, your financial agent steps in to keep your financial life running smoothly if you become unable to do so.

Choosing an Agent: Because this person might be managing your bank accounts and property, pick someone who is responsible and trustworthy with money. It could be a close family member or friend with good judgment. You can also name more than one co-agent, but be cautious – having two people with equal power can lead to conflicts or confusion. It’s usually simpler to name one primary agent at a time, with one or two successors in case the first can’t serve. Always name at least one backup agent in your financial POA. If your agent were to become unavailable and you had no alternate and then you lost capacity, there’d be nobody able to take over, potentially forcing court involvement.

Powers Granted: The Colorado statutory form power of attorney lets you grant authority over a whole range of subjects – from real estate, personal property, banking, investments, to taxes and government benefits. You can initial the specific areas you want your agent to handle, or give general authority for all areas. You can also withhold certain powers if you don’t want your agent to do something. Think through any special instructions you might want.

Who Should Have an Advance Directive?

Every adult can benefit from having advance directives. While we often think of these as forms for “seniors,” unexpected health crises can happen at any age. That said, they are especially crucial for:

• Older Adults: As we age, the likelihood of medical events or cognitive impairment increases. Having your wishes documented and agents in place is vital for anyone in their retirement years.
  
• People with Serious Health Conditions: If you’re living with a chronic illness, or you’re about to undergo major surgery, creating advance directives should be high on your list. It ensures your ongoing care aligns with your preferences.
  
• People with a Major Life Event: If you just got married or divorced or moved across the country, the people closest and most accessible to you may have changed.
  
• Younger Adults: If you recently turned 18, you’ll know that your parents no longer get to automatically make decisions on your behalf. If you are someone who has always trusted your parents to make the big decisions, you might want to give them back that authority with a Power of Attorney designation.
  

Final Thoughts

Speak to an attorney about how to set up these documents. You can choose when the documents become active – immediately or upon a certain event (durable vs springing). There are pros and cons to each type, so it is imperative that you know exactly how they both work. It is also important to understand how your death impacts these documents. These documents are only for your incapacitation – while you are alive. Once you pass away, then a will or trust will dictate what happens to your estate.

Take some time to think about what kinds of medical interventions you would or wouldn’t want in dire situations. Who in your life would be best at carrying out your wishes for health care or managing your money? It might help to talk with family or your doctor about these questions. Clarity now will make it easier later. You can always update these documents, so it is important to revisit them periodically to ensure they still reflect your wishes. 

Once signed, don’t shove the papers in a drawer and forget them! Give copies to the relevant people, such as your agents, close family members or friends, your physicians, and financial institutions.

Advance directives give you control over the “what-ifs” in life. They are a gift to those who care about you, guiding them to do what you would want. Don’t delay. Your future self – and your family – will thank you for it.