Deciding Now for Later
HHRC will help you make arrangements for lifelong healthcare, so that your time with family can be unburdened and your wishes will be respected now and later.
Durable Power of Attorney for Healthcare Decisions
You can use this form to name an individual, typically called a “DPOA,” who can legally make health care decisions for you during a time of disability or incapacity.
Your selected DPOA should be able to uphold your wishes for healthcare decisions, regardless of their personal preferences. The powers granted usually include decisions about health care, choice of physicians, and long term care. The healthcare agent (DPOA) may not cancel a person’s Living Will.
Your DPOA must be a legal adult and competent when the document is signed. It is important for you to share personal wishes and desires about health decisions with the DPOA.
Declaration – Living Will
Use this form, commonly called a “Living Will,” to state in advance whether you want your life to be artificially prolonged in case of terminal illness. The Living Will gives your DPOA and physician(s) directions for your end-of-life wishes.
The Living Will applies only when a patient has been diagnosed and certified terminally ill by two physicians.
On this form, you’ll state in advance what specific treatment options you would or would not want to receive. Use this form to help your DPOA understand your treatment preferences.
Do Not Resuscitate Order Request
This form allows you to elect to not receive Cardio-Pulmonary Resuscitation (CPR) used when you are in a terminal state in your disease process. This decision may be made by only you and your DPOA. In the state of Kansas, a physician’s signature is required.
This form states: “If my heart stops beating or if I stop breathing, no medical procedures to restart breathing or heart functioning will be instituted. No resuscitation will be attempted.” This form does not stop all treatment measures; it only stops resuscitation efforts.
Kansas Durable Power of Attorney
This document provides authority to another person to make financial decisions on your behalf.
Medical Alert Information
First Responders can use this information to best care for you in times of critical emergencies. The Medical Alert Information will provide crucial information about your medical conditions, diseases, and medications.