Imagine yourself lying in the hospital unable to communicate because your hands and feet are tied down, a tube in every orifice. There are machines whirring constantly and bright lights on 24 hours a day. You are writhing in pain and being poked and prodded by different people. You have no chance of recovery. What would you want done in those circumstances?

Many people do not want to exist is such a state but are unable to communicate their wishes at that point in time. In order to avoid ending up helpless in those circumstances, people can execute "advance directives" and make their wishes known ahead of time.

An advance directive is generally a written statement, which you complete in advance of a serious illness or accident, about how you want medical decisions made. It allows you to state your choices for health care or name someone to make those choices for you, if you become unable to make decisions about your medical treatment. In short, an advance directive can enable you to make decisions about your future medical treatment. You can say "Yes" to treatment you want, or say "no" to treatment you do not want.

The two most common forms of advance directives are "living will" and "durable powers of attorney for healthcare decisions." In Nevada, a living will is a declaration directing a physician to withhold or withdraw life sustaining treatment. It will only go into effect if you have an incurable, irreversible condition; and you are not able to communicate your desires.

Many people are concerned if they execute a living will they will not receive pain medication or food and water. Nevada law specifically provides that the execution of a living will does not affect the responsibility of your doctor to provide treatment for your comfort or alleviation of pain. With respect to food and water, you may state in your living will you do not want food and water withheld or withdrawn.

In Nevada, a "durable power of attorney for health care decisions" is a signed, dated and witnessed paper naming another person, such as a husband, wife, daughter, son, or close friend as your "agent" or "proxy" to make medical decisions for you should you become unable to make them yourself. You can include instructions about treatment you want to avoid, such as surgery or artificial feeding.

If you choose to have an advance directive, you should make sure that someone, such as a close friend or family member, knows you have one and knows its location. You should keep it in a safe place where it can be found easily. You should also keep a small card in your purse or wallet, which states you have an advance directive and where it is located. Lastly, you should ask your physician to make your advance directive part of your permanent medical record.

In conclusion, remember the key word in "advance directives" is advance. These documents need to be done before a crisis strikes and it is too late to execute them.

If you are over the age of 60 and a Washoe County resident, you may obtain assistance from the Senior Citizens Law Project by calling 328-2592,

If you are a senior citizen in Churchill County, please contact Nevada Legal Services at 883-0404. All other senior citizens in northern Nevada counties, please contact the Carson City Senior Center at 883-0703.

If you are a senior citizen in Clark County, please call 702-229-6596.

Despina Hatton is the directing attorney of the Senior Law Program at the Washoe County Senior Services Center.