Making uncomfortable decisions now helps loved ones later

What’s an advance directive, and how do I make one?

“Advance directive” is a term that covers several kinds of documents, like medical powers of attorney and living wills. An advance directive tells your family and friends what to do for you if you can’t speak for yourself – you make the decisions now so you’ll be ready when you can no longer make them.

• Living will – You might think a living will takes care of everything. However, a living will only covers very specific, limited circumstances, and what it covers varies from state to state. For example, the standard living will in most states lets you give instructions on whether to give treatment that prolongs life without improving it, whether to stop giving food and fluids through a tube or IV, and whether to donate your organs when you die. A living will does not cover decisions like how you’re cared for if you’re sick, at what point that care should change, or whether you go to a hospital, nursing home, or stay at home.
  
  
• Advance illness planning goes into more detail than a living will. To plan for illness, you need to imagine what would happen if you suffered from dementia, had an accident that caused permanent brain damage, or if you had recurring cancer that caused intense pain. Advance illness planning requires a written description of your wishes in any event, which is witnessed and notarized to ensure your wishes will be followed.
  
  
• A medical power of attorney assigns a specific, trusted person as your healthcare agent, to make decisions about your health and care when you’re unable to do so. It’s a legal document that assigns one person, and no one else, to determine what action to take. It can be combined with a living will or advance illness planning to cover anything that’s not included in those documents.

No matter what you do, you need to sign the finished document in front of two witnesses who know you well and can testify that you know what you’re doing. Some states also require advance directives to be notarized.

Once you’ve created your advance directive, you need to make sure it’s followed. The only way to do that is to let everyone know where to find the document if something happens to you. If it’s locked away in your lock-box at the bank, no one’s going to be able to find it. Put your documents in a place that’s secure, but easy to locate – you could even give copies to your two witnesses. It is also recommended you give a copy to your doctor. In addition, most hospitals and outpatient care centers will ask whether a patient has a living will and request a copy for their records.

And I need to do this because …?

You may think your family and friends know what you’d want if you were ill and unable to decide for yourself. You may think they’d do what you want. But have you talked to them? Are you sure?

For that matter, have you thought all this through for yourself? End-of-life decisions are more than just when to discontinue treatment. They involve your personal beliefs and values, what’s important and why. Having a legal advance directive that covers all the bases means one less thing for you – and your loved ones – to worry about.

The bottom line

Although it’s not pleasant to think about, planning for illness makes sense. Taking on the tough tasks now allows others to avoid them later, and ensures you’ll be treated the way you choose.

For more information

• Advance illness planning help
  
  
• Estate planning: Honoring your wishes
  
  
• What is a living will?
  
  
• Sample of a living will