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Why You Need a Living Will – and How to Get Started Today

None of us wants to think about dying. But at some point in the future, you may not be able to speak for yourself about end-of-life medical care due to the effects of a serious injury or illness. If this happens, your family will have the responsibility of making medical decisions for you. Will they know what your wishes are?

“Making medical decisions for a loved one can be a heavy burden for family members,” observes UAB geriatrician and palliative medicine specialist Amos Bailey, MD. “An advance directive document — or living will — is a gift to your family because it provides them guidance and support in making important and difficult medical decisions for you.”

The Five Wishes Document – Helping to Start the Conversation

While you can develop a living will the help of an attorney or elder law specialist, Dr. Bailey recommends the Five Wishes document as a useful tool for addressing the major questions related to end-of-life care. This brief, easy-to-read document meets the legal requirements for a living will in 40 states and is useful as a planning tool in all states. You can visit www.agingwithdignity.org to download the document on your computer or order a copy to be sent by mail (either option is a $5.00 fee).

“I routinely use the Five Wishes document as a way to help patients have conversations with their families about the kind of care they would want when facing a terminal or incurable illness,” says Dr. Bailey. “We also use the document to teach medical students and residents how to have conversations with patients about their preferences regarding end-of-life care. While facing these questions ahead of time can be uncomfortable for many people, the Five Wishes document can help to make the conversation easier.”

Using everyday language, the Five Wishes document helps you express to your family and doctors:

  • Who you want to make health care decisions for you if you are unable to make them for yourself.
  • The type of medical treatment you want or don’t want (including extraordinary measures to extend your life).
  • How comfortable you want to be.
  • How you want people to treat you at the end of your life.
  • What you want your loved ones to know.

“A good advance care planning document — such as Five Wishes — gets to the heart of a patient’s values,” stresses Dr. Bailey. “The issues that arise during end-of-life care are always unique, and it’s difficult to cover every contingency. For this reason, it’s important to understand the values that are important to a patient.”

Check www.agingwithdignity.org to find out if the Five Wishes document meets the legal requirements for a living will in your state. If not, you can use Five Wishes as a planning tool, then have the document translated through an attorney to meet your state’s legal requirements. “For example, there is ambiguity is the Alabama state law regarding which forms are legally approved by the statute in the Alabama Code,” says Dr. Bailey. “However, most physicians and families would welcome guidance in any form available to help make the wishes of a loved one known.”

While Five Wishes — and other advance directives — allow you to name someone to make medical decisions for you, Dr. Bailey offers a word of caution. “If the person you’re appointing is outside of your family — and children and other family members may want to override the direction of the appointed person – make sure you consult with an attorney to be certain this portion of the document is legally binding.”

Dr. Bailey concludes that everyone – especially senior adults and those with chronic conditions — should express their wishes about end-of-life care in the form of a living will. “The Five Wishes document is an excellent tool that can help you start the conversation and focus on the values that you want to communicate.”

Article last updated: December 3, 2009 10:10 AM