Advance Directives: A Gift You Can Give

Advance directives allow an individual to make decisions regarding life support and other terminal care. Not only does this give you the opportunity to make your own decisions, but it also removes those difficult decisions from having to be made by a loved one.

Advance Directive Assistance

Langdon Prairie Health assists with advance care planning. If you have questions or need help completing an advance directive, contact our Advance Care Planning Certified Facilitator at 701-256-6189 to schedule an appointment.

What is Advance Care Planning?

Advance care planning is a process of making decisions about the care you would want to receive if you become unable to speak for yourself. These are your decisions to make and are based on your personal values, preferences, beliefs, and discussions with your loved ones.

Your wishes and preferences can be stated in an advance directive, which is a legal document that goes into effect only if you are incapacitated and unable to speak for yourself. This could be the result of an illness, disease, accident or other unexpected event.

By creating an advance directive, you have the opportunity to plan ahead for what type of care you would want; it also helps others know what your wishes and preferences are for healthcare. Advance care planning can help reduce stress and anxiety for individuals and their families.

Advance Care Planning includes:

  • Selecting a substitute decisionmaker (i.e., healthcare agent) who will make decisions on your behalf if you are unable to speak for yourself.
  • Deciding what types of treatment you would want if you were diagnosed with a life-limiting illness or a permanent brain injury. It may help to talk with your medical provider about how your current health conditions might influence your health in the future.
  • Getting information on the types of life-sustaining treatments that are available.
  • Reflecting on your values and goals and what is important to you. In considering treatment decisions, your personal values are key.
  • Putting your wishes and preferences in writing by completing an advance directive.

Why have an advance directive in place?

If you do not have an advance directive in place and you become seriously ill or injured, your doctors, hospital staff and loved ones will do the best they can. However, without clear direction from you, your loved ones may have to guess what you would want.

If there is any uncertainty about your wishes, care could be delivered that may not be consistent with your wishes. If you want people to know – and follow –your wishes, you should talk with them about your preferences and have a written and signed advance directive in place.

Advance Directives: Common Questions & Answers

An advance directive is a written document that allows you to:

  • Give instructions about any aspect of your healthcare
  • Choose a person to make healthcare decisions for you (i.e., healthcare agent)
  • Give instructions about specific medical treatments you do or do not want
  • State your hopes and wishes for end-of-life care
  • Give other instructions, including organ donation, etc.

An agent is an adult who you give the authority to make healthcare decisions for you, as provided in your advance directive.

Your agent should be someone you know and trust, who knows how you feel about medical treatment, who understands your beliefs and values, and who is willing to carry out your wishes.

You should talk to your medical provider or some other medical professional who can tell you about various kinds of medical treatments, services, procedures, or life-sustaining care.

Yes. You will be able to make your own healthcare decisions as long as you are capable of doing so. Your advance directive only takes effect when you become incapacitated, or when the conditions you have identified in the advance directive are met.

No. It is not necessary to have an attorney involved in completing an advance directive. However, if you have questions about legal matters, you may want to consult an attorney.

You should keep your original document in a place that is easy to find in the event that you become unable to make or communicate your decisions. You should provide a copy of your advance directive to your medical provider and any other healthcare agencies who are providing care for you, such as a hospital. Also, provide a copy to your healthcare agent(s), close family members, and other significant people who may need to know your healthcare preferences.

Advance Care Planning is an ongoing process. You should review your advance directive regularly because your health, goals and values may change. It is recommended to review your advance directive when the "Five Ds" occur:

  • Decade - when you start each new decade of your life
  • Death - whenever you experience the death of a loved one
  • Divorce - when you experience a divorce or other major family change
  • Diagnosis - when youare diagnosed with a serious health condition
  • Decline - when you experience a significant decline in your health, especially when you are unable to live on your own

If you make changes to your advance directive, you should complete a new advance directive form, and provide copies to the people indicated above.

Advance directive forms and Advance Care Planning Information Packets are available at Langdon Prairie Health. Advance directive forms are also available online at

Life-Sustaining Treatments

CPR Facts You Should Know

CPR is done for you by someone else. It can include:

  • Breathing into your mouth and pressing on your chest
  • Electrical shock and drugs to try to start your heart
  • A tube to help you breathe

CPR does not help as much as most of us think. CPR works best if:

  • You are healthy with no illness
  • It can be given to you within a few minutes of when your heart or lungs stop working
  • You have chronic health problems
  • You have an illness that can no longer be treated
  • You are older and weaker
  • If you are in the hospital and get CPR, you have a 22% chance of it working and leaving the hospital alive. If you are older, weaker, and living in a nursing home, CPR works less than 3% of the time

If CPR does help to get your heart and lungs to work, it usually has side effects:

  • Your lungs are weakened and you will need to be on a breathing machine for a period of time
  • You will need to he cared for in an ICU
  • You may have brain damage
  • You may have damage to your ribs

You should talk to your medical provider about these side effects.If you want to try CPR, you should talk about what results you would expect and what your goals would be. If you decide that you do not want to try CPR, you need to tell your doctor and family.

What to Know About Ventilators

Ventilators are machines that help you breathe. A tube connected to the ventilator is put through the throat into the trachea so the machine can force air into the lungs. Putting the tube down the throat is called intubation.

Because the tube is uncomfortable, medicines are often used to keep you sedated while on a ventilator. If you are expected to remain on a ventilator for a long time, a doctor may perform a tracheotomy. During this bedside surgery, the tube is inserted directly into the trachea through a hole in the neck.

For long-term help with breathing, a trach is more comfortable, and sedation is not needed. People using such a breathing tube are not able to speak without special help because exhaled air does not go past their vocal cords.

About Artificial Nutrition and Hydration

If you are not able to eat, you may be fed through a feeding tube that is threaded through the nose down to your stomach. If tube feeding is needed for an extended period, a feeding tube may be surgically inserted directly into your stomach.

If you are not able to drink, you may be provided with IV fluids. These are delivered through a thin plastic tube inserted into a vein.

Artificial nutrition and hydration can be helpful if you are recovering from an illness. However, studies have shown that artificial nutrition toward the end of life does not meaningfully prolong life. Artificial nutrition and hydration may also be harmful if the dying body cannot use the nutrition properly.