Life can take unexpected turns. Despite the advances in health care that help people live longer, there could come a time when you are unable to communicate what medical care you need. Planning for such a time while you are healthy not only ensures your wishes are known, it also protects your loved ones from having to make difficult and personal choices for you.
Livings wills and medical power of attorney documents are written, legal instructions about your preferences for medical care. Called advance directives, these documents guide choices for doctors and caregivers if you are terminally ill, seriously injured, in a coma, in the late stages of dementia, or near the end of life.
What is a Living Will?
Despite its name, a living will is not the same type of will that you would use to leave property after death. A living will details what you do and do not want in terms of medical care if you are unable to speak for yourself.
How Does a Living Will Work?
Each state has its own living will form, allowing you to state your wishes in as much or as little detail as you like. To be valid, a living will must meet state requirements regarding witnesses and notarization. The document can take effect as soon as it’s signed, or only when you can no longer communicate your wishes about treatment. You may cancel or change your living will at any time, but you will need to tell your doctors and everyone else who has a copy.
What Should a Living Will Include?
When determining your wishes, think about what is important to you. Talk to your primary doctor, other health care providers, family, and friends as you make your advance directive decisions so your wishes are clear and understood.
Be specific about what kind of medical procedures you do or do not want performed. Consider the following:
- If your heart stops beating, would you want to be resuscitated by cardiopulmonary resuscitation (CPR) or by a device that delivers an electric shock to stimulate the heart?
- If you stopped breathing, would you want a mechanical ventilator to take over your breathing for you? If so, for how long?
- Tube feeding supplies the body with nutrients and fluids intravenously or via a tube in the stomach. Would you want to be fed this way, and if so, for how long?
- Dialysis removes waste from your blood and manages fluid levels if your kidneys no longer function. Would you want to receive this treatment, and if so, for how long?
- If you were near the end of life, would you want infections to be treated aggressively or would you rather let infections run their course?
- Comfort care (palliative care) includes any number of interventions that may be used to keep you comfortable and manage pain, while abiding by your other treatment wishes. This may include being allowed to die at home, getting pain medications, being fed ice chips to soothe dryness, and avoiding invasive tests or treatments.
- Organ and tissue donations for transplantation can be specified in your living will. If your organs are removed for donation, you will be kept on life-sustaining treatment temporarily until the procedure is complete. To help your caregiver avoid any confusion, you may want to state in your living will that you understand the need for this temporary intervention.
- Donating your body for scientific study also can be specified.
Living Wills After Death
Any authority granted by a living will ends when the person who made the document dies, with the single exception that some living wills or powers of attorney give your caregivers the power to make decisions about organ donation or autopsy.
While the conversation may be difficult, communicating your end-of-life issues is important. Take the time to share your wishes with your physician and family. The more these individuals know, the easier it will be for them to carry out your wishes.
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