Planning

Your Living Will

A living will tells others how you want to be treated when it comes to life-sustaining measures. It is used when a person becomes terminally ill or unable to communicate or make decisions, the National Cancer Institute (NCI) says. Such a will doesn't always tell doctors to withhold or end treatment. In fact, it can call for treatment to go on regardless of your medical condition. Having a living will protects your rights as a patient and means that your family or friends aren't left with the burden of making difficult decisions about your care.

Many people avoid getting an advance directive for the same reason they often don't want to think about a will. People tend to think that serious illness or death is not going to happen to them, that they are immortal.

Beginning at age 18, you should put into writing how you feel about life-support systems, what your desires are, and who you want to make decisions for you if you can't make them for yourself.

Issues to consider
When putting together a living will, you should think about the issues or types of life-sustaining care, the NCI says. These include:

• Life-sustaining equipment, such as dialysis machines, ventilators, and respirators
• Do not resuscitate orders, which mean medical staff are not to use CPR if your breathing or heart stops
• Tube feeding or supplying fluids by tube
• Withholding food or fluids
• Palliative care, or care that provides comfort
• Organ and tissue donation 

You can refuse aggressive medical treatment, but still allow treatment that focuses on comfort. Such treatment could include antibiotics, nutrition, pain medication, and radiation therapy, the NCI says.

Make it legal
Write down your wishes
Once you sort through your feelings, you must write down your preferences so that your caregivers and health care providers know how to care for you. Your message to your health care providers is known as a living will. Legal forms vary from state to state. If you spend time in more than one state, it's crucial to know each state's rules. You can check with a lawyer about what you will need, or you may find free forms and help by visiting the National Hospice and Palliative Care Organization website. Any forms you use must be signed, dated, and witnessed.

It's best to be as specific as possible. Avoid vague statements such as, "Just let me go peacefully." In a crisis situation, caregivers need clear direction, which also helps avoid conflicts. Make sure that your family, friends, health care team, and hospital or other health care providers all have a copy of your advance directive so that it can be easily accessed and followed.

Your personal advocate
You will need someone to make decisions for you if you aren't able to do so. The person you choose should be named in a legal document known as a durable power of attorney. For health decisions, this person is often called your health care proxy. Pick someone who understands you, respects you and your wishes, and can make difficult decisions in times of stress. Explain your end-of-life preferences and ask if he or she will honor your wishes. If the answer is "yes," you've found your advocate. You can designate your durable power of attorney to make financial and other decisions for you as well, should you become incapacitated.

An advance directive will contain the two legal documents you need: your living will and your durable power of attorney.

How much do you know about advance directives? Click here to take our quiz!

If you would like to talk about an Advance Directive for Health Care for yourself or a loved one, please contact Lakeland's Chaplaincy Services at (269) 983-8454 or by emailing at rmiota@lakelandhealth.org.

Information to Keep Handy

If someone asked your adult children when you last saw a doctor, could any of them answer? What if you were asked for a list of specialists you've seen in the last five years or the results of hospital tests you've had in that period? Can your spouse find your living will (advance directive) or health care proxy forms?

The time to pull all that together is now, when you have time, experts on aging say. If you need admission to a long-term care facility, for instance, having the right documents gathered together can ease the process. Missing information may slow admission.

Collect your information
How can you ensure you'll get the services you need in the future? Gather information that you might need now. If you get sick, you may need a living will, health care proxy, and information about your health insurance and medical history. If you go to the hospital, you should have a copy of your living will with you. If you require nursing home care, you will need your medical history and financial information as well as information on any hospital admissions. It helps to have a record of the names and addresses of your health care providers, the dates of your office visits, and hospitalizations.

Other information that might be needed on short notice includes birth certificates, bank statements, proof of insurance, military discharge papers, and proof of assets.

It's important to remember that situations change. You may have adequate finances at the start of care. But within a couple of years, or even a few months, you may need to apply for Medicaid, the state and federal health care program for people who have exhausted their assets. Then it may become important to produce certain financial records that weren't needed earlier.

It's easy to say you'll cross those bridges when you reach them. But taking the time now to organize records will actually build those bridges.

To start building

• Get a large notebook. In the front, write your full legal name, Social Security number, legal residence, and information on health and life insurance, including policy numbers.
• On the next page, write your date and place of birth, the name and addresses of your spouse and children, and where your will can be found.
• Use the notebook to document any special arrangements you've made for care. If you've named a health care proxy, completed an advance directive, or set up a living will, note the details and the document locations.
• Record the location of other important records, such as your birth certificate, military discharge papers, bank statements, and mortgage papers.
• Use the rest of the notebook to track your current medical history. Write the date, time, name, and phone number for any health-related visit. List reasons and outcomes.
• In a separate file, put records on sources of income and assets, Social Security and Medicare data, investment information, bank accounts, and safe deposit box locations.
• Ask for copies of medical records and hospital discharge records. Put them in an expandable file you keep with the notebook.
• In another expandable file, put copies of all important financial and legal documents. Keep this file with your other records.
• When you start to gather information, tell more than one relative or trusted friend you're doing it and where it is.

Documents you need
Check off each item you assemble, then write down its location. When you've checked off every item, put the list with your important papers. Tell trusted friends or relatives where it is.

Personal items:

• Birth certificate
• Marriage license
• Divorce papers
• Citizenship papers
• Military discharge
• Prearrangements for burial

Financial items:

• Social Security records
• Medicare documents
• Investment records
• Negotiable securities
• Insurance records
• Bank statements (both checking and savings)
• Credit card information
• Most recent income tax return
• Mortgage papers
• Loan papers

Legal documents:

• Power of attorney
• Will
• Trust documents
• Health care proxy
• Living will (also known as an advance directive)