How Do I Fill Out Oregon’s Advance Directive Form?

by Patricia Louise Nelson

Introduction:

Oregon’s Advanced Directive allows you to appoint someone to make healthcare decisions for you, if you become unable to communicate your wishes to your doctor. It is crucial that every section of this important form be completed correctly. Let us go through it together.

Sections One and Two:

In sections One and Two, you fill in information about yourself and your healthcare representatives. The latest Oregon Advance Directive form requests all contact information for your healthcare representatives, including home, work, and cell phone number.  Please provide all the information you can.  The point of having an address on this form is so that the authorities can locate your healthcare representative in case of an emergency, including possibly knocking on their door. I would therefore recommend that you use physical addresses, as opposed to a PO box.

Section Three:

Section Three is where you need to make your first decision. You need to pick either the first choice or the second choice, but you cannot choose both. If you choose the first option, your health care representative must follow the instructions you provide in the balance of the document. The second option allows your healthcare representative to make decisions for you, using your instructions as guidelines. On the one hand, if a health care representative makes decisions that result in your death, that could leave the person with a sense of guilt. On the other hand, if you require your health care representative to follow your instructions, that leaves them with no discretion.

Section Four:

Section four gives you the opportunity to give directions regarding your end-of-life care.

Part A:

In Section Four, Part A, if you initial A, it’s a shortcut. It is the same as initializing “I do not want tube feeding” and “I do not want life support” under every choice in Section Four, Part B.

Part B:

Section Four, Part B covers four conditions: Close to Death, Permanently Unconscious, Advanced Progressive Illness, and Extraordinary Suffering. For each of these conditions, you can decide whether you want tube feeding, whether you want tube feeding only as your health care provider recommends, or whether you do NOT want tube feeding.  In addition, you may make the same choices about whether you want any other life support that might be available to you.

Part C:

Section Four, Part C gives you an opportunity to provide your healthcare representative additional instruction.  In the actual form this is a blank line. In our form, we have inserted an additional option. It is a reference to the Dementia Provision. The actual Dementia Provision is the last page of our draft Advance Directive.  If you like that provision, you need to initial Section Four, Part C on the bottom of page four of the Advanced Directive form.

We have taken the Dementia Provision as it was drafted by Compassion And Choices. It allows you to decide now whether you want to be fed or given fluids if you have advanced dementia and you could potentially live for years if you were given a feeding tube and intravenous fluids. If you do not want to, you circle “do not” on each of these choices, sign and date the form.

As you can see, it is a tricky form. Please let us know how we can help you fill it out.