A 70-year-old man arrived at a Florida emergency room unconscious, critically ill and without any form of identification. As his care team sprang into action, they found he had a tattoo on his chest that said “DO NOT RESUSCITATE” with his signature tattooed below.

The team of physicians was unsure about how to proceed: should they honor the man’s tattoo as his binding wish, or take lifesaving measures to help revive him? A previous case from five years earlier outlined the story of a man with a similar tattoo who said he wanted lifesaving measures to be taken in the event he needed them, and that the tattoo was simply the result of a lost bet. 

While the hospital scrambled to identify the man, physicians began weighing the ethics of the man’s case. As physicians, they didn’t want to choose an irreversible treatment path when they were faced with the uncertainty of the man’s true wishes. The hospital’s ethics committee disagreed and suggested it was reasonable to assume the tattoo reflected his wishes.

Thankfully, the hospital was able to find his Florida Department of Health order, which was consistent with the man’s tattoo, before it was too late. The man’s health worsened through the night, and he passed away without receiving unwanted medical care.

Unfortunately, situations like these are far too common when a family member becomes seriously injured or ill without previously outlining their healthcare preferences. Making life-changing decisions in a moment of crisis can lead to disagreements and unnecessary stress on loved ones.

You can see the importance of making your healthcare preferences known from the story above, not only for your own health and safety, but also for the emotional well-being of your family. And a tattoo does not constitute a proper advance directive.

Image of a woman signing her advance directive document at the kitchen table surrounded by family

How Do I Make My Wishes Known?

An advance directive is a document with legal instructions that outline your healthcare preferences if you become unable to make your own choices known. This information guides your physicians, care team and loved ones on how to approach your care if you are terminally ill, seriously injured, in a coma or near the end of life.

This includes information like:

  • The use of dialysis and breathing machines
  • If you want to be resuscitated if your breathing or heartbeat stops
  • Tube feeding
  • Organ or tissue donation
  • Durable power of attorney to declare someone you trust as the person to make your healthcare decisions if you are unable to do so

When Should I Create an Advance Directive?

As soon as possible – all adults should have an advance directive, no matter what their age. These documents can be updated throughout life if your wishes or situation changes.

How Do I Fill Out an Advance Directive?

Each state uses a different form for advance directives and has different laws. You can download your state specific advance directive form online and it becomes legally binding when you sign it with the appropriate witnesses present – no need for an attorney or legal fees.

What Do I Need to Know to Fill Out the Advance Directive?

It’s important to do your research before you fill out the form. Consider the following:

  • Learn the types of life-sustaining treatments that are available in different healthcare situations
  • Decide which types of treatment you do or do not want – and try to do it free from influence – this is about you and your preferences
  • Discuss your wishes with your family so they know you wishes and are not shocked by what you include in your advance directive
  • Think about special requests you may have, such as: organ donation, burial vs cremation, etc.
  • Read the document fully before filling it out so you can make sure you have all the information you need

What Do I Do Once I Have Filled Out My Advance Directive?

You want to make sure the document is always available, no matter where you are. The National Hospice and Palliative Care Organization recommends these suggestions:

  • Make several copies of the completed document
  • Tell family members where you keep the original document and the photocopies
  • Don’t lock the document away – you want people to be able to access it
  • Give a copy to your physician and anyone else who may be involved in your healthcare
  • Check to see if your local hospital will file the document in the event you are admitted in the future
  • Try storing the document with an electronic service such as MedicAlert or U.S. Living Will Registry so the document is available while you’re traveling and protected at home from theft, fire, flood and natural disaster 

Your physician can also advise you on end-of-life planning at any phase in your healthcare journey. If you or a loved one are receiving home health care or hospice care, advance care planning is one of the valuable services included in your benefits.

To learn more about home care and hospice services, call 1.866.KINDRED to speak with a registered nurse 24 hours a day, seven days a week. We are here to listen and help.

Have you completed an advanced directive? Let us know about your experience in the comments below. 

By Blair Klayko