Write a Living Will

A Living Will, also known as an Advance Healthcare Directive or Advance Medical Directive, is a legal document that provides your family, doctors, and caregivers with information about what life-saving measures you wish to undergo should there come a time when you are unable to communicate your wishes. This includes resuscitation options, guidelines of medications to give, and your wishes regarding life support. Living Wills work in concert with other medical directives, such as Do Not Resuscitate orders and Medical Power of Attorney.

Steps

Understanding a Living Will

1. Know the purpose. A Living Will is intended to convey your instructions for life-sustaining medical treatment in the event of a terminal illness or serious accident. It names someone to serve as your agent. This person, often a spouse or family member, consults the information provided in the documents and makes decisions about your care.
2. Learn the risks not having a Living Will. Without a Living Will, you risk having decisions about your medical treatment made without consultation. This includes starting, maintaining, and ending life support systems, even if the person in control knows that the decision is against your wishes. Without a Living Will, your family members and loved ones may disagree about the right course of action in an emergency.
   • Often, it is easier for people to make life and death decisions when they are guided by your wishes in a Living Will. It also reduces the stress on loved ones at an already stressful time.
   • Additionally, your wishes are more likely to be followed and respected by your loved ones if they have guidance in writing.
3. Understand the limitations. A Living Will is not the same as a Last Will and Testament. The Living Will does not provide instructions for any disposition of your property after your death, with the exception of organ donation.
   • Living Wills also do not cover every situation. For example, you may need treatment that is not contemplated by your Living Will. In this situation, you will need an agent appointed by a Medical Power of Attorney to make medical decisions for you when you are incapacitated.
4. Create a Medical Power of Attorney. In addition to a Living Will, you should also create a Medical Power of Attorney (also called a “Healthcare Power of Attorney”). With this legal document, you will appoint someone to make medical decisions for you should you become incapacitated. Whereas a Living Will only applies if you are in a terminal condition, a Medical Power of Attorney will apply so long as you are incapacitated.
   • In the Medical Power of Attorney, you appoint an agent who can consent, refuse, or withdraw consent for any type of medical care or procedure.
   • For more information on medical power of attorney, consult wikiHow’s Write a Medical Power of Attorney.
5. Create Physician Orders for Life Sustaining Treatment (POLST). POLST programs are designed to assure that the medical treatment wishes you express are honored by health care professionals as you move from one health care setting to another. They are available in about a dozen states. POLST programs are helpful if the health care workers do not have access to your Living Will, or if your Living Will is not specific enough to envision the different treatments that you may or may not want.
   • POLST can substitute for a Do Not Resuscitate (DNR) order. With a DNR, you can state that you do not want CPR. However, a POLST is much broader and also states your wishes with respect to intubation, antibiotic use, and feeding tubes.
   • Doctors sometimes will also ignore a Living Will. For this reason you should create a POLST, if one is available in your state.
   • To make sure that your wishes are carried out, you will need a Living Will, a Medical Power of Attorney, and a POLST. All are necessary, especially if you are facing an imminent end-of-life situation.

Preparing to Write a Living Will

1. Talk to your doctor. Before writing a Living Will, make sure that you speak with your doctor and clearly understand what your choices would mean. You do not want to make these decisions lightly. Some of the terms used in a Living Will can be confusing, and you need to ask your doctor to explain each of them so you can make the best decisions for you.
   • For example, make sure you understand the difference between resuscitation and life support. Resuscitation is the act of bringing a person back to life after the heart has stopped. Life support is a system, such as using a ventilator or feeding tube, that will keep you alive when you cannot do so on your own.
2. Discuss your decisions with your family. You should discuss your wishes with your family and loved ones. This will help you get an idea of whether they would be comfortable carrying out your instructions. When you make your Living Will, you want to make sure your family will not interfere with your wishes when you cannot defend your choices.
3. Consult with a lawyer. You should talk to an experienced trusts and estates attorney to discuss not only the Living Will but other directives, such as a Medical Power of Attorney. An attorney can answer any questions you have. You can find an experienced trusts and estates attorney by visiting your state’s bar association website, which should run a referral program.
   • Look for certification. Many states certify attorneys in Estate Planning and Trust law. Ohio, for example, has a specialization in Estate Planning, Trust and Probate Law. To qualify, attorneys must prove that they have devoted a significant percentage of their practice to the field, receive recommendations from other attorneys or judges, take continuing legal education courses in the field, and pass a written examination. Other states have similar programs and standards.
   • You may also look for someone certified in Elder Law. Elder law attorneys routinely handle end-of-life issues for clients.
4. Appoint an agent. When you make a Living Will, you need to appoint an agent. This is the person who will carry out the stipulations in your Living Will. Since your agent is not monitored, make sure that who you consider appointing is not opposed or uncomfortable with your choices. You want to make sure your agent will follow your instructions and not waver based on personal feelings. Typically, people choose a spouse or an adult child as agent.
   • When considering who to appoint as your agent, decide whether your spouse is likely to be emotionally overwhelmed by your medical crisis. If so, you may want to choose another relative in order to spare your spouse the agony of following your wishes.
   • This is also true for any other family member, such as a child or sibling, who you might consider as an agent. You do not want to cause your loved one too much emotional strain in the situation. Whoever you choose, make sure that they share your ethical and religious values.
   • Make sure you tell the individual you choose as your agent. You do not want it to be a surprise if she needs to undertake the responsibilities of the position.
   • Whoever you choose needs to be willing to enforce your Living Will. It is not unusual for doctors and hospitals to ignore provisions contained within a Living Will. Your agent will need to clear and forceful with medical professionals while advocating on your behalf.
5. Define the authority of your agent. In your Living Will, you can define the amount of authority that you would like your agent to have. Generally, giving the agent broad authority is best, because then the agent is more likely to be able to carry out your wishes in an unforeseen situation. You can also appoint alternate agents in case your first choice of agent is not available. However, you should only appoint an alternate if you fully trust him to carry out your wishes.
6. Disqualify individuals as an agent. You can also explicitly disqualify people from serving as your agent. You may want to do this if you are very concerned that someone will try to override or not follow your wishes due to a disagreement with your views. Make sure that you consider any state restrictions on who can be named as your agent.
   • For example, in most states, there are certain people that cannot be your agent in a Living Will, such as your doctor, staff of health care facilities or nursing home facilities that provide your care, employees of government agencies, or any person who is already an agent for someone else.
7. Change your mind. You can change or cancel your Living Will at any time and for any reason. If you do decide to cancel, you should immediately notify anyone who has a copy of the Living Will, including your agent and your doctor. If possible, destroy all copies and make a new one, if you decide to do so.

Writing a Living Will

1. Get the appropriate form. Many states provide Living Will forms. You can use one of these forms, but you are not required to do so. If the form does not properly fit within your circumstances, you may consider not using the form and drafting your own Living Will.
   • To look for forms in your state, perform an online search for “living will forms in [the state where you live].”
   • Illinois has a sample form here. Florida’s form is here.
2. Prepare your own document. If you choose to complete your own Living Will document, you will need to follow a certain formula. This will ensure that it has all of the necessary information and it will be legally binding. There are 8 sections that need to be included in your Living Will, each covering a specific stipulation for your care.
3. Write sections 1 and 2. Section 1 discusses the health care agent. This section includes your name as the creator of the Living Will, and the full name, address, and telephone number of the person who you appoint as your agent. Section 2 names your alternate agent. Make sure to include any alternate agents that you want to name.
4. State the effective date and durability. In section 3 of your Living Will, you need to state the date from which your Living Will will be effective. Typically, statements such as “if and when the writer cannot make health care decisions” are used to describe the date when the Will goes into effect. In this case, a doctor will determine when this happens unless you state otherwise.
   • You can have an alternative start date for your Living Will if you desire. You can also state that the agent’s power will end at some later date or after an event other than your death.
   • For example, one doctor might make the determination of incapacity, but you can specify in the Living Will that you would like two doctors to make this decision for you.
5. Define the agent’s powers. In section 4, you need to define what specific powers you want to grant to your agent. The grant of power to your agent in a Living Will should be as broad as possible. If you set specific limits, your agent will not have the authority to make any decision that you could make to continue or stop any type of health care.
   • However, even under this broad grant of power, the agent still must follow your wishes and directions that are set out in sections 5 and 6.
6. Describe the instructions for end-of-life treatment. In section 5, you need to describe the specific guideline for how you want your medical treatment to be handled. You can give general or specific instructions about your wishes for end of life care. You should include particular instructions about issues such as blood transfusions, electroconvulsive therapy, amputation, certain types of surgery, and resuscitation.
   • For example, you may instruct your agent to refuse any specific types of treatment that are against your religious beliefs, such as a blood transfusion or life support, or anything that is unacceptable to you for any other reason.
7. Explain limitations or additional instructions. In section 6, you need to explain any other health care instructions that do not deal specifically with end-of-life matters that might arise while you are unable to help yourself. You also need to discuss any limitations on the agent’s power.
   • For example, you may want to include your wishes about medical treatments that might be suggested but that are not required to keep you live. You can also explain if you want your agent to agree to your admission to a nursing home.
8. Input protections for third parties. In section 7, you should lay out any protection given to third parties who follow your agent's decisions. In most states, health care providers cannot be forced to follow the instructions of your agent if they object to them for any reason. However, most states also require providers to transfer you to another provider who is willing to honor the Living Will.
   • You should include this section to encourage doctor compliance with the Living Will without the fear of being held liable civilly.
   • For example, if you state in your Living Will that “no person who relies in good faith on any representations by my Agent shall be liable to me, my estate, or my heirs for recognizing the Agent’s authority,” the doctor might feel more comfortable following whatever wishes you state in section 5 and 6.
9. Specify organ donation options. In section 8, you need to specify if you want to donate your organs at the time of your death. If you would like to donate your organs, you should put this in your Living Will. If you are already an organ donor, you do not have to specify this unless you want to make sure your wishes get followed.
10. Sign your Living Will. Once you have a completed your Living Will document, you must sign and date the document for it to go into effect. You should also get the document signed in the presence of a notary to prevent any future problems. Some states also require you to have the document witnessed, so check your state to ensure your Will will be legally sound.
    • If you are required to have witnesses, choose people who know you personally and who will be able to declare that you appear to be competent and are not acting because of undue influence.

Tips

• This article is for information purposes only. State laws may change and you should contact a trusts and estates attorney if you have any questions.
• Be sure you're alive before making a living will. Some good ways to do this are checking your pulse, exercising, catching feels, and/or breathing.

Sample Advance Directive and Template

Doc:Advance Directive,Advance Directive Template

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