Discussing wishes for end of life care is one of the most avoided yet also one of the most important conversations concerning one’s health. Talking about these issues and putting them in writing is something every adult, regardless of their health, should do. In fact, talking with your family and/or your doctor about your wishes is often even more important than the legal writing down of these wishes. Completing a written advance directive can also be an important springboard to having these discussions with the people you love.
Understanding End of Life Planning
So, to start with the basics, advance directives are documents written in advance of serious illness that state your choices for health care, or name someone to make those choices, if you become unable to do so. Advance directives typically have two parts, a durable power of attorney for health care and a living will. You can have either or both.
Durable Power of Attorney
A durable power of attorney for health care, also known as a health care proxy, allows you to name a person (or persons) you want to make health care decisions for you if you are unable to make them for yourself. A durable power of attorney for health care is not the same as a power of attorney for financial matters. A health care proxy must be 18 years old, can be a family member or a friend, should be someone who knows you well, and, most importantly, must be someone you trust to follow your wishes who will be available (either in person or by phone) to talk with your health care team if needed. Your health care provider cannot serve as your health care proxy. Identifying a health care proxy allows your family to avoid disagreements or even legal battles about your care.
A living will spells out for your family/friends and your health care team the type of medical care you want or do not want if you become terminally ill and you are unable to make your own decisions. Individuals can be very specific or very general in these documents. Often a living will includes a statement about whether a person would want artificial respiration (ventilator) if they are unable to breathe on their own. It can also include choices about feeding tubes, certain medications, and life-prolonging treatments like dialysis. Again, the living will is only considered in the event that an individual is permanently unconscious or otherwise unable to make decisions for him/herself.
Completing an Advance Directive
There are a variety of advance directive forms available. In almost all cases, advance directives can be completed without an attorney, and most states do not require the form be notarized (only witnessed). Forms can be obtained through your health care provider or your local area agency on aging. Once you have completed an advance directive, it is important to give a copy to your doctor and to your family members. One of the main reasons people are uncomfortable having conversations about end of life wishes is that we don’t do it often enough. However, most people say that they and their family felt a big sense of relief after completing an advance directive.