It's never too early to make a
could happen at any time. Walk across the street and get hit by a truck. Hop
into your car and encounter a drunk driver. Suffer a sudden, acute illness and
find yourself hospitalized. Any of these could end your life. Or, they could
leave you mentally or physically incapacitated.
If it happened to you, would you be ready? Would you have
your affairs in order so your doctor and family would know what your health
care wishes are? If not, perhaps it's time to consider some sort of advance
directive so you can control your own health care even if you can no longer
express your wishes.
Contrary to what you might think, living wills and other
advance health care directives aren't only for the elderly. Disaster can hit
anyone at any age. The time to make your health care decisions for the future
is now -- while you can. Not only will you assure yourself that your health
care wishes will be followed, you will take some of the burden off family members
who might be left to make those health care decisions for you.
A will to live by
We tend to use the term "living will" rather loosely. Actually,
when we speak of living wills, we're speaking of a two-pronged approach to making
our health care wishes known called advance directives. Preparing a living will
is one part of a comprehensive advance directive plan. The other is preparing
a durable power of attorney for health care. Together, these two documents can
give you peace of mind regarding your health care wishes for the future and
are an important part of your estate planning.
A living will is a legal document in which you direct your
physician regarding the withdrawal of life support if you become ill and have
a terminal condition, are in an irreversible coma or a persistent vegetative
state. All states recognize the legality of a living will, though you should
check your state for the particulars. In a living will, you can specify exactly
what your doctor is to do if you, in his or her opinion, cannot recover from
your illness or accident and are no longer capable of making your own decisions.
At the very least, your living will should address what your physician is to
- Cardiac resuscitation
- Mechanical respiration (ventilator)
- Artificial nutrition (feeding tube)
- Artificial hydration (IV)
- Pain medication and oxygen therapy
- "Do Not Resuscitate" orders
Before making your living will, decide how you feel about
these issues. Would you want the doctor to withhold nutrition and hydration,
for example, if you had a stroke? If you were terminally ill? If you were a
victim of dementia or senility? If so, you need to prepare your living will
to deal with those possibilities.
You can make your living will as specific as you like regarding
these situations. In other words, you can direct your physician that, if you
cannot get well, you don't want to be resuscitated nor do you want to be placed
on a ventilator for artificial breathing. Be very specific about how you feel
about artificial nutrition and hydration as states differ in their laws in that
area. Also, be specific if you want "comfort measures." Comfort measures
include anything to make the end easier for you although they will not prolong
your life. Examples of comfort measures are pain medication and oxygen therapy.
You can even draw up your living will to reflect that you do indeed want life
support measures to be taken and under what circumstances.
Passing on the power
Even though a living will gives direction to your physician, it is also
advisable to have a durable power of attorney for health care. This document
differs from a living will in that you appoint an agent, or proxy, to make medical
decisions for you in accordance with your wishes. Be sure that the person you
appoint as your agent is ready and willing to serve in that capacity. The decisions
that person has to make and enforce will not be easy. For example, withholding
artificial nutrition and hydration from a loved one is very difficult for most
people. Be sure that your agent understands the implications of serving in your
stead and is prepared to make and enforce difficult decisions. Often, two individuals
are appointed in this capacity. The second individual is appointed in case the
first choice cannot or does not want to serve.
The durable power of attorney for health care is perhaps
even more important than the living will. Living wills generally address the
desires of patients in the most dire of circumstances. If you have a health
care agent appointed through a durable power of attorney, however, that individual
can make other types of health care and treatment decisions for you if you are
not competent to do so yourself. Examples would be day-to-day care and treatment
options. In addition, living wills often need interpretation. Your health care
agent, presumably someone who knows you well, would be able to supply that interpretation.
Even though you can prepare these documents yourself, you're
safer if a qualified attorney prepares them. The attorney will know the specifics
of the law within your state. After preparing your advance directive, you need
to supply copies to your physicians and your health care agent so they will
be available if needed. If you move to a different state, most states recognize
the advance directives of other states. You can change the terms of your living
will and durable power of attorney for health care at any time.
Tips to remember
In summary, here is a short list of tips on preparing your living will
and advance directive:
- Determine your feelings about living wills and what they
- Decide on the specifics that you want your living will
to address such as resuscitation and artificial nutrition.
- Decide if you want to specify comfort measures in your
- Decide if you want to prepare a durable power of attorney
so a person close to you can help make your medical decisions if you cannot
- Choose one or two individuals to serve in the capacity
of your health care agent.
- Name the agents in the durable power of attorney and
be specific about the types of decisions they can make as well as your own
- Have an attorney prepare your living will and durable
power of attorney and distribute copies to your physician and health care
Most individuals have their living wills and durable powers
of attorney prepared at the same time they prepare their last will and testament.
But don't wait too long. Anything can happen at any time and you want to be
in control of your health care decisions even if you become incapacitated.
-- Posted: March 16, 2003