When you think of the end of your life, you usually don’t think of all the medical decisions that go along with it. This can lead to serious stress for your family, especially in unexpected end-of-life situations.
Fortunately, you can plan ahead with a living will and other advanced directives (ADRs). These are written, legal instructions that outline your preferences for medical care in situations where you are unable to make decisions for yourself. With ADRs, your family members will not have to choose, or disagree on, what care you might have wanted. They will also not have to make difficult decisions in the aftermath of an emergency or the early phases of their grief.
Health Care Agents
Instead, the individual you choose to make decisions on your behalf, or your “health care agent,” will use your living will and medical directives to communicate and implement your wishes. This person will also be charged with making decisions that aren’t mentioned in your ADRs. Your health care agent cannot be part of your medical care team and should be someone you trust and who meets your state’s requirements for medical power of attorney. Some people choose their spouse, other family members, or even their friends.
We also recommend you nominate an alternate health care agent, as well, in case the person you chose originally is unable or unwilling to fulfill the role.
Things to Think About in a Living Will
In your living will and advanced directives, you should specify the medical treatments you want and those you do not. We encourage clients to consider their values when drafting their living will. Are there some situations where your survival is not worth preserving? Should you be kept alive if recovery is not possible? Along with these questions, you will need to decide whether or not you want:
- Cardiopulmonary resuscitation (CPR) and defibrillation – restart your heart when it has stopped beating – decide if you would want 1 or both of these methods to be used.
- Mechanical ventilation – takes over your breathing when you cannot breathe on your own – decide if you would want to be placed on a ventilator and for how long.
- Tube feeding – supplies nutrients with an IV or stomach tube – determine if and how long you would want to be fed this way.
- Dialysis – replaces the function of your kidneys – decide if and how long you would want this treatment.
- Antibiotics or antiviral medications – do you want these kinds of treatments at the end of your life?
- Palliative care – care to keep you comfortable, like pain medications – what kind of interventions do you want while your other treatment orders are being followed?
- Organ and tissue donation – specify whether or not you want to donate your organs and clear any life-sustaining procedures that ensure a successful donation.
- Cadaver donation (for scientific study) – plan ahead to donate your body to research.
With a living will and advanced directives that address these questions and other possible treatments, your medical team will be able to provide the care you prefer, even when you cannot communicate your preferences.
Other Important Directives
Whether or not you have a living will, you should also have do not resuscitate (DNR) and do not intubate (DNI) orders if you do not wish to undergo these treatments. You can establish DNR and DNI orders every time you are admitted to a new hospital or health care facility. If you are admitted while incapacitated, the directions on your living will can help communicate your wishes.
In hospitals or nursing homes, you may also have physician orders for life-sustaining treatment (POLST), which is separate from your living will. You and your doctor develop this document and post it near your bed, so all medical professionals who treat you know what treatments should and should not be used.
Living wills and other advanced directives must be in writing and meet the requirements for legal documents. In most places, the documents need to be signed by a witness or notarized. If you draft your ADRs with an attorney, your attorney will work with you to create legally binding documents. Your attorney can also help you provide copies to the proper parties and keep track of these copies in case you need to make changes.
You should review these advance planning documents whenever you are diagnosed with a terminal disease or one that has a significant impact on your life, when your marital status changes, or about every 3 to 5 years. Revisiting your ADRs helps you keep your wishes consistent with your values and beliefs. You can update or cancel any ADR at any time.
Living wills and other advanced directives are important legal documents. If you are just starting to think about these things, having the guidance of an attorney can be helpful. At Bailey | Stock | Harmon | Cottam | Lopez LLP, we are skilled in estate planning and can help you better understand various aspects of your end-of-life decisions. With our 175 years of combined legal experience, neither you nor your loved ones will have to suffer uncertainty during a difficult time.
Call us at (307) 222-4932 or contact us online for a free consultation.