Life is a one-way journey, and contemplating how the trip may end is not easy to do. But it’s important to make decisions about your future medical care while your health still allows you to do so—and to put those wishes in writing. Preparing an advance directive—a document that describes the type of medical care you’d want if you were to become unable to make medical decisions—will help your doctors follow your wishes and spare your loved ones agonizing decisions.
If you’re ill or admitted to a hospital, your doctors may talk to you about writing an advance directive, but it’s better to think about your wishes when you’re well, no matter what your age. The case of Terry Schiavo, who lived in a persistent vegetative state for more than a decade while her family feuded in courts about removing her feeding tube, brought to national attention the importance of having an advance directive. Schiavo was just 25 when she suffered devastating and irreversible brain damage.
An advance directive is normally made up of one or two parts: a living will and/or a durable power of attorney. In a living will, you express your desires about life-sustaining treatment you’d choose or refuse. In this type of directive, you should:
- spell out the measures you wish taken to extend your life
- state if and how you want breathing machines, feeding tubes, oxygen, resuscitation efforts, intravenous fluids or other medications to be used, as well as your wishes about organ or tissue donation
- list specific conditions, such as coma, incurable illness or end-stage dementia, under which the terms of your living will go into effect
Because it’s impossible to plan for every situation in your living will, a durable power of attorney for healthcare appoints a family member or friend to be your healthcare proxy or agent and to make decisions for you regarding your end-of-life care. This person’s duty is to make treatment choices for you that would comply with your wishes if you couldn’t make them yourself.
Your advance directive doesn’t have to be complicated, but you do need to put everything in writing. You can get a form from either your healthcare provider or a Web site like the AARP’s (www.aarp.org) or the National Hospice and Palliative Care Organization’s (www.caringinfo.org). State laws vary, but usually you need to sign and date your documents before two witnesses. You can change your advance directive at any time. Be sure to discuss your advance directive with your loved ones and your healthcare provider and supply copies of your documents to them for safe-keeping.