Advance Directives

Give a Gift...Your Living Wish

All You Need Are Three Documents:

These are not just “end of life” documents. They are for all ages. These documents are just as important for an 18-year-old as they are a 100-year-old. We all have wishes related to the care we want or don’t want to receive.

  1. Healthcare Power of Attorney (HCPOA or HPOA): A person appointed to make healthcare decisions for you in the event you cannot make a decision for yourself. Make sure this person is in absolute agreement with your wishes.
  2. Living Will: Provides directions for everyone on what care you want or don’t want to receive.
  3. DNR (Do Not Resuscitate):
    DNR-CCA (Comfort Care Arrest) – You wish all medical treatments/interventions to be done up until the point your heart or breathing stops.
    DNR-CC (Comfort Care) – You wish for comfort measures, supportive and/or symptom management to be done only. No surgery. No CPR. No aggressive medical treatments.
    Please note a DNR document is not required if you wish to be a full code.
  4. Keep in mind a DNR does not stop you from receiving medications and/or medical treatment.

Frequently Asked Questions:

Do I really need these documents? Everyone over age 18 needs a Healthcare Power of Attorney. This allows an appointed person to speak for you when/if you cannot. It gives you the opportunity to share your wishes with that person(s). The Living Will allows you to share with others when you do not want life support if you are in a coma or are dying. A DNR allows you and your doctor to tell others when you do not want to receive life sustaining care.
Will these documents be difficult to complete? These documents are easy to complete as they are all about you.
What if I change my mind later on? They are easy to change and you should review them every few years just to be sure you haven’t changed your mind about something.

How to Complete the Documents:

You may complete the documents on your own. The documents must be made valid by a notary (banks and many local businesses/agencies have notaries available to assist you) or by two non-family witnesses who are not named in the document. Keep in mind that witnesses must be present at the same time of the signing.

You also may have assistance with completing the forms by making an appointment to sit down with a patient representative at FMC at 740-687-8555. To complete the DNR document, you must meet with your doctor.

You also are welcome to walk into FMC and pick up the documents at either the North or South Information Desks. Local hospice/home care agencies, lawyer’s offices and doctor’s offices also are good places to find assistance with completing the documents.

Once documents are completed, please share with:
-Your local hospital
-Your doctors (primary care physicians and specialists)
-Person(s) named in the document
-Place a copy on the front or side of your refrigerator so EMS or first responders can easily find your documents
-Put a copy in the glove box of your car

Review the advance directives packet and forms (PDF)
DNR Comfort Care form (PDF)

During your admission process, you will be asked if you have an advance directive (living will and/or durable power of attorney for healthcare), and if not, whether you would like information on how to complete one. Advance directives are your written instructions for the medical treatment you want in the event that you are unable to communicate your wishes. Bring advance directives copies with you for your medical record.

If you currently have a do not resuscitate (DNR) or “No CPR” advance directive in place, please notify us immediately. You will have the opportunity to discuss this with your physicians and staff prior to your scheduled procedure.

If you are scheduled for a procedure or surgery and have questions, contact Pre-Surgery Testing at 740-689-6314.
Questions related to Advanced Directives and/or DNR, may be called to our patient representatives at 740-687-8555.