Before you get sick, it’s important that you put in writing the instructions for what kind of treatment you would want and who could make decisions for you if you could no longer communicate your wishes.

Many people assume that their family members would automatically be able to make decisions about medical treatments and life-sustaining measures if they were to become incapacitated. This is not always true!

Rules vary greatly from state to state but in some cases, decisions are left up to doctors and institutions unless you have appointed someone as your legal representative. If the decision falls to family, your family members may not always agree on medical treatment issues, which could lead to extended court battles over appropriate treatment, particularly regarding end-of-life issues.

Ideally you should have a range of the following documents that describe how you want medical and financial decisions handled if you can no longer make them yourself:

• A health care proxy and a living will

  While each document serves a unique purpose, they work best together. In many states they are combined into one "advance directive" document.

  Generally, the most important document to have is the health care proxy (in different states, you may hear it called a “durable power of attorney for health care,” “medical power of attorney” or “appointment of a healthcare agent”). This document allows you to name someone you trust—such as a spouse or friend—as your “proxy or agent” to make health care decisions for you if you are unable to communicate your wishes because of temporary or permanent illness or injury. This person can generally make almost any medical decision you would and can respond to changing circumstances.

  A living will has a more narrow scope than a health care proxy. It describes the type of care you want to receive as you near the end of your life in specific circumstances. It typically goes into effect only when your doctor certifies your health condition and that you are no longer capable of making decisions (“incapacitated”). You may also hear a living will called a “directive to physicians,” “health care declaration” or “medical directive.” It works best as a guide for your agent and physicians.

• Power of attorney

  A “power of attorney” is a document that allows another person (your “agent” or “attorney in fact”) to make property, financial and other legal decisions on your behalf. Your agent may play an important role in your health care, as he or she can pay for health care, choose health insurance policies for you and appeal coverage denials.

You may appoint the same person to be in charge of medical and financial decisions, but to do so requires two separate documents.

Your doctors should make note of your living will and health care proxy in your medical record, and you should give these documents to the hospital upon each new admission. If you are going to be taken to the hospital by ambulance, take these documents with you if you can.

To find out more about health care proxies, living wills and powers of attorney, click on the links in the GO TO box.