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Wherever possible, get family support by asking your closest ones to respect your wishes as a sign of love for you. Discuss your advance directive with them from time to time.
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Complete the form by ticking the options you accept and by scribbling out the options you reject so there can be no misunderstanding as to your preferences. If you are not sure or don’t care about a particular option, leave it blank and understand that others will decide for you regarding that option.
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It is very helpful to your treating doctor (who is likely to be a complete stranger in an emergency) to know something about you and your values. Write a bit about yourself on the blank pages or attach separate notes. What is important to you? What you most fear about your wishes not being respected? Your notes help make you a "real" person to your doctor even though you cannot communicate.
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Sign and date the advance directive in front of an independent witness. We recommend that this be your doctor if possible. Most doctors are very willing to act as witnesses. Alternatively, a nurse or a JP.
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Ask your doctor to apply their service provider stamp next to their witness signature. This lets other doctors know that you have had medical involvement in the completion of your advance directive.
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Ask your doctor to copy your advance directive to your medical centre’s patient file and to place an "alert" on it, bringing it to the attention of anyone at that practice who is treating you.
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At the same time, ask your doctor to send a copy of your advance directive to your hospital and to put an "alert" on it there, too. When next you see your doctor, check that this has been done.
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Ask a trusted person to act as your "agent" – see the "Guide to Dying" booklet for information. Prefer an assertive person if possible. Your agent needs to be willing to accept this role. They should have a copy of your advance directive. Their only job is to bring it to the attention of your treating doctors and to argue for your wishes to be followed if necessary.
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Review your advance directive regularly and make changes whenever you wish.
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Even if your advance directive stays exactly the same, re-sign at least every 5 years and get it re-witnessed (preferably by your doctor). Go through the same steps as above.
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If you suspect loss of mental competence (e.g. dementia or similar), re-sign more frequently, e.g. every 6 months. This shows the enduring nature of your intentions.
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Paramedics are trained to look for an advance directive/documents in your fridge if no-one is around to ask. So seal at least one copy of your advance directive into an air-tight plastic bag, then place it in a brightly coloured folder in your fridge – bright yellow attracts attention best. Label the folder clearly.
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If your whānau/agent believes your wishes are not being respected in a hospital/care facility, they are within their rights to threaten court action on your behalf for "assault".
