Representative Advance Directives

For Consensus-Based Family Decision Making

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Are you a family member confronted with making medical decisions for a loved one who never completed a living will or other advance directive? 

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Or, perhaps your loved one has completed a written document, but it offers you no meaningful guidance.  What are you to do?

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Are you are a medical professional faced with helping a family make important treatment decisions without an adequate advance directive?

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Or are you a, judge, guardian, conservator or other legal representative charged with gathering important information for medical decision-making?

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Obtain a representative "consensus" directive based on applicable statutes, court rulings, and other accepted guidelines

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Designed for use by families, medical providers, conservators, guardians, senior care advisors, and others

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Use it to guide advance planning and medical decision-making for those no longer able to decide for themselves

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Lifecare's "Representative Advance Directive" and Guidebook (only $7.99 and $5.99, respectively; bulk discounts available)
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It is not uncommon for loved ones to have delayed completing an advance directive until it is too late -- i.e., until after their capacity for legal decision-making has been lost.  This may be due to the effects of a stroke or from a degenerative brain disease such as Alzheimer's, etc. 

The greatest assurance of accurate, patient-preferred treatment choices is best secured through a personally completed advance directive.  However, where advance planning has not occurred (or where the document used is too vague or confusing to be useful), family members can and should assist in making necessary medical choices. 

Infact, the American Bar Association has noted:

"Indeed, the most common yet most misunderstood practice ... is family consent.  This [practice] has deep cultural roots.  Doctors and hospitals commonly rely on consents, as well as refusals from family members." (see: American Bar Association. Patient Self Determination Act State Law Guide. American Bar Association. Commission on legal problems of the elderly.  August 1991. )
In like manner the American Geriatrics Society has noted:
"... AGS has long encouraged the use of oral and written advance directives, or the participation of traditional surrogates, such as close family members, to aid in this process." (see: American Geriatrics Society.  Making treatment decisions for incapacitated older adults without advance directives.  Journal of the American Geriatrics Society.  1996;44:986-87)

In recognition of this, family representative medical decision-making has been  widely authorized -- either through specific statutes or by explicit case law (prior court rulings), and/or by accepted and nationally endorsed practices and policies.

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Often, however, those involved in decision-making are unaware of the applicable state-specific guidelines.  Even more frequently, family members, medical providers, court-appointed representatives and others lack quality tools by which to organize and finalize crucial medical decisions.  The results of poor planning are often burdensome, or even tragic, and may include:

  • Unnecessarily delayed treatments and medical care;
  • Family conflicts, discord, anger and estrangements;
  • Unnecessary demands upon medical providers and ancillary support staff in addressing preventable conflicts and concerns; and,
  • Unnecessary petitions to the courts -- either to resolve preventable conflicts, or through expensive and burdensome repeat returns for further court orders that could easily have been obtained previously.
Think of the Terri Schiavo case, and many, many more like it.  To learn more, click here

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The Representative Advance Directive provides quality comprehensive medical advance planning.  It draws upon specific statutes, laws, court rulings, and policies to aid families, medical providers, and/or other court-appointed representatives to accomplish the following:

1) Identify the proper decision-maker(s) as endorsed by law or other relevant guidelines. 
2) Gather essential information from important family members and others about the individual's previously known wishes. 
3) Avoid, address, and/or more easily resolve issues of conflict. 
4) More efficiently and completely prepare for the court appointment of a guardian or conservator, if this ever becomes necessary; and,
5) Securing advance court orders whenever needed or possible, specifically including the most commonly encountered health care concerns.


The Representative Advance Directive contains all essential advance planning decisions found necessary through the research conducted for the Lifecare Advance Directive.  This document was derived from a review of more than 6,700 medical, legal, academic, and mainstream media articles on advance decision making, comparative analysis of more than 100 existing advance directive types and formats, as well as input from scores of medical, legal and academic specialists.  Finally, it was concluded with university-guided research involving more than 1,000 formal study participants.  Thus, families and physicians can be confident that all major decisions necessary can be fully and  comprehensively addressed through the Lifecare Representative Advance Directive, as well. 

The Representative Advance Directive can make an otherwise stressful and trying decision-making process much less difficult.  It can also aid families, physicians, and others to explore and secure an incompetent individual's known wishes well in advance of need, thereby avoiding the significant stress that comes from urgent decision-making without adequate advance planning, understanding and preparation. 

Finally, if a petition for guardianship or conservatorship of a person becomes necessary, and/or if treatment decisions must be approved by the courts, the Representative Advance Directive can be particularly helpful.  Not only will it aid in more promptly identifying an appropriate family-nominated guardian (whenever possible),  but its comprehensive advance planning approach can also minimize the need to repeatedly return to the courts for further orders that could have been obtained in advance.

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As one state supreme court has noted, certain advance planning orders are not only acceptable, they are to be preferred.  Specifically the court noted that, without advance decisions, life-sustaining treatments in particular must always be used, or at least begun, as:

"...there will be no time to get... authorization [to withhold them]...once an emergency arises."The court therefore found that failing to make advance decisions amounted to "a decision by default" (see: In re Guardianship of Grant, 109 Wash.2d 545, 747 P.2d 445 (1987)).

It is far better for families and physicians to come together well in advance to make carefully considered and heartfelt choices in the best interests of someone they love, than to wait until stressful emergencies arise when extended family discussions and decision-making may no longer be possible.

The Representative Advance Directive is designed to accomplish this preparatory planning with a minimum of confusion, conflict,  and decision-making neglect.

Don't delay.  Order a Representative Advance Directive now for a loved one in need of advance planning and actively assist in important and much-needed advance medical planning. 

Obtain a copy ($7.99)
click here


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