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Advance Directive Health Care Proxy

Federal and state law provides a way for your health care wishes to be carried out should you ever become unable to speak for yourself. The law allows you to select another person to make health decisions for you.

It is important to designate a health care agent who will make medical treatment decisions on your behalf should you become unable to do so. Your designated agent or proxy will have legal authority to oversee end-of-life care decisions in keeping with your wishes, allowing your physicians to provide the best possible treatment and care. This important advance directive provides your loved ones with the guidance to make these critical decisions in keeping with your end-of-life care preferences.

What are advance directives?

Advance directives are legal documents providing you the opportunity to express your healthcare wishes in writing so that your voice will be heard when you can no longer speak for yourself. Advance healthcare planning involves thinking, talking and preparing so that treatment decisions made are consistent with your needs and desires.

Why do I need an advance directive?

Accidents and sudden illness can occur at any age, so it is important to take the steps necessary to ensure the best possible outcome for a worst case scenario. If advance healthcare planning is taken seriously and properly communicated, a designated agent or proxy will have legal authority to oversee end-of-life care decisions, allowing your physicians to provide the best possible treatment in conjunction with your wishes. It also provides your loved ones with the proper guidance to make these critical and difficult decisions in line with your intentions.

The Five Wishes Document

The Five Wishes document is an advance directive that helps you express your wishes in your own words regarding the kind of care you want to receive in advance of a serious illness. It aims to ensure that your wishes will be respected even if you can't speak for yourself. It is unique among all other living will and health agent forms because it covers all of a person's needs: medical, personal, emotional and spiritual. The Five Wishes lets your family and doctors know:

  • Which person you want to make healthcare decisions for you when you cannot
  • The kind of medical treatment you want or do not want
  • How comfortable you want to be
  • How you want people to treat you
  • What you want your loved ones to know

How can I get an advance directive?

If you would like an advance directive, or need help completing one, ask your nurse or physician, or call the patient representative at 978-937-6458. When signing the document, you will need to have two witnesses present (age 18 or older) who are not named as your agents to sign the document as well. No lawyers are needed to make the form valid.

We urge you to discuss with your healthcare providers any questions that may be helpful in voicing your needs and wishes. We also emphasize the importance of discussing how you would like to be treated with your family and loved ones.

The Five Wishes document is available through our Admissions Office. It may also be obtained online or by phone for only $5. Click here to order or to learn more.

The completion of this form is strictly voluntary.

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