Advance Directives | Community Health Network

"Advance directives" is a general term for seven different legally recognized documents or procedures that citizens of Indiana have the right to complete, informing caregivers how they want their medical care handled if they are unable to communicate.

The types of advance directives are:

Talking directly with your physician and family
Organ and tissue donation
Living will
Health care representative
Durable power of attorney
Life prolonging declaration
Psychiatric advance directives

You may choose one or more of these advance directives. Federal law requires that each inpatient be asked if he or she has an advance directive.

With the healthcare options you have today, you might feel overwhelmed or unsure. If you feel uncertain about the right thing to do, you may ask a case manager, social worker or chaplain to talk with you. You may have other family or friends help in this talk. The final decision, however, is yours.

You may also want to consider being an organ or tissue donor. As you may know, donors help several other people have a better quality of life. If you want to be a donor, let your family, physician, clergy, and others close to you know of your wishes. They can support those wishes at the time of your death.

Forms and More

CHNw Advance Directives Forms and FAQ

Indiana State Department of Health Advance Directives brochure (Adobe PDF)
This brochure helps answer questions about advance directives, living wills, power of attorney, organ and tissue donation, and more.
Indiana Out of Hospital Do Not Resuscitate form (Adobe PDF)
This is the legal form in Indiana for Do Not Resuscitate declaration (State Form 49559)
Indiana Advance Directives Resource Center
Official legislation for the State of Indiana defining Do Not Resuscitate
MedicAlert information
The Indiana State EMS Commission has designated MedicAlert as the only acceptable and approved identification device for Out of Hospital Do Not Resuscitate patients.
Indiana Donor Network
IDN provides assistance to donor and recipient families, bereavement programs, and other services vital to organ donation.

End of Life Reflection

These questions are designed to help you reflect on your own feelings about the eventuality of your own death. This is a delicate issue in many ways. Our culture usually tries to avoid the issue of death and dying. However, a person's ease in dealing with issues of death and dying may be well developed, and with little denial, depending on developmental education, training, and experience regarding death. These questions will help you determine your own level of comfort with the issues surrounding death, and will help you discuss these issues with your loved ones.

Do you have current advance directives (living will, health care representative, power of attorney for health care matters, or life prolonging declaration) on file, and do the necessary people know about your wishes (family, physician, clergy and friends)?
Have you decided if you want to be an organ/tissue donor, and if so do others (family, physician, clergy, and friends) know of your wishes?
Are you aware of your patient rights? These rights are:
- To refuse treatment
- To a second opinion
- To change physicians/staff
- To informed consent
- To respectful treatment
- To have your pain managed well
Are you aware that you have responsibilities as a patient? These are responsibility to:
- Give complete medical information
- Treat medical staff with respect
- Comply with medical guidance
- Pay medical bills
Have you completed your funeral planning (pre-planned services, cemetery plot, worship service, etc.)?
Do you have updated estate planning (will, guardianship of children, living trusts, etc.)?
Were you to die in an auto accident today, would others know how to handle day-to-day events you normally do (bills, insurance, financial papers, lock box location, unfinished work, contact with friends, colleagues, family, etc.)?
Were you to die today, would your present sense of meaning and purpose, and fulfillment in life allow you to die with some sense of satisfaction with your life?
Were you to die today, would your family know about your life’s meaning?
Is your spiritual/religious life, e.g. your relationship with God, at a place that would allow you to die with a sense of spiritual fulfillment and peace?
If someone close to you died today, would you have regrets about issues or conflicts (unfinished business) that you avoided resolving with that person?
Do you celebrate life (e.g. play freely with your kids, tell people what you appreciate about them, and take time to simply enjoy being alive)?
When death occurs in your experience (family, friends, pets, plants, etc.), do you reflect openly on this with yourself and with your family or friends?
Do you see a relationship between how you deal with your own mortality and how available and helpful you are to others facing death?