Steps to completing an AD

You now have enough basic information to begin completing your AD. To complete your AD, follow these recommended steps carefully:

1. You must first give careful thought to your values about quality of life when you are dying. Most individuals have personal preferences that make a “one size fits all” AD impossible to write. Use some of these questions and instructions to prompt your thinking. Once you have considered some of your preferences, try writing a paragraph or two describing what treatments you would or would not want, and under what circumstances. In your writing, try to be very simple and clear, and don’t worry about grammatical correctness. Several of the Web sites listed on our resources page may be useful to you.

2. When you have written several paragraphs you like, contact one or two trusted friends or advisors and ask them to read what you have written. Does it make sense to them? Is there anything that confuses them instead of providing information about your wishes? Do they think of any additional questions you should think about?

   If so, then revise your paragraphs and ask for a fresh review. Continue this writing/review process until you are satisfied that the statements represent your basic treatment preferences at the end-of-life. Remember, your goal is to make a document that is likely not misunderstood.

3. Meet with your family members and share what you have written. If possible, have a conversation with them about any questions or concerns you or they might have. It is possible that some revisions to your paragraphs may occur as a result of this sharing. You might also discuss the question of who your decision maker will be.

4. Decide whether or not you want to name a surrogate decision maker or rely on the proxy list. Carefully consider your decision. If you wrote 100 pages of paragraphs about your treatment preferences, you wouldn’t be able to directly address every issue that might need to be decided. You will need a person who knows you, understands your preferences, and will steadfastly represent you and your wishes.

   If you want to name a surrogate, then our section on selecting a surrogate suggests how you might go about selecting exactly the right person.

5. Once you have written instructions about your treatment preferences, and have either identified a surrogate, or left this blank, then you are ready for signatures. Your name and date come first. Then you want two witnesses, one of which may be a family member. The other must not be a family member. Each should date his/her signature.

6. You should now make sure that key persons in your life receive a copy of your AD. Family members should be in this group. If you have a minister, attorney, or close friend, these are good persons to get a copy of your AD. When you go to your physician and/or are admitted to a hospital, take a copy and ask that it be placed in your medical record. Make sure that the original signed document can be easily located by your surrogate or family member.

7. Make a plan to review your AD every 2-3 years. This is to make sure that it still reflects your wishes. If not, then revise it and share these revisions with your selected Surrogate and family. If no changes are required, then simply reinitial it with the current date. Give family members, etc. an updated or new copy of your AD.

Reminders about completing your AD

• You will need two witnesses when you sign your AD. One of them can be a family member, but the other must not be a family member.
• You may cancel or revise your AD any time you are capacitated and able to make your own decisions.
• Your AD does not go into effect until you can no longer understand and speak for yourself. Prior to your becoming incapacitated, your physician should ask you to make your treatment decisions.
• Just because you have a written AD does not mean that your loved ones understand your treatment preferences. You must talk with them about your wishes before your AD goes into effect.
• An AD is not the same as a Legal Will, which lists your finances, property, possessions, etc., and what you wish to be done with those.
• Laws about ADs vary from state to state, but usually each state will respect an AD from another state. However, if you completed an AD in a state other than Florida, and you now reside in Florida, it would be advisable to complete an AD that reflects Florida law. All of the information presented to you about ADs is compliant with current Florida law.

Can I change my AD?

You may change your AD any time you wish. This includes altering a paragraph, changing a surrogate, or writing an entirely new AD.

If you decide to alter your AD at any time, be sure to retrieve all copies of your old AD and distribute copies of your new AD. If the information regarding your preferences has changed or you have decided to select a new decision maker (surrogate), it is important to inform your loved ones of these differences.