What Is a Living Will?
A living will is a document that contains your wishes for what kind of medical care you desire and how aggressive you want the healthcare providers to be in caring for you. Some living wills include the option for you to designate a medical power of attorney in the same document as you indicate your various healthcare choices. Others are drawn up in separate documents. This can vary by state and by document. Note that not all states will recognize a living will but regardless, it is a helpful tool to communicate your preferences.
Why Is a Living Will an Important Document for People with Alzheimer's?
A living will is a good document for everyone to have, but especially so in Alzheimer's disease and other kinds of dementia. Because dementia is progressive, you can anticipate that the ability to make decisions, including medical ones, will deteriorate. A living will provides you with the opportunity to outline ahead of time what your wishes are and how you want your medical decisions to be made.
What Kinds of Decisions Can You Communicate in a Living Will?
Living wills vary from state to state, but many states allow you to express almost any choice about your medical treatment in a living will. You might include the following:
- Durable Power of Attorney for Healthcare
Some living wills include an option to designate someone to serve as your medical decision maker, also known as a patient advocate, healthcare proxie or patient representative. A healthcare power of attorney document ensures that if you are not able to make medical decisions, the person of your choice is empowered to do so.
- Code (Resuscitation) Status
You might choose to communicate that you do not wish to receive cardiopulmonary resuscitation (CPR) if your heart stops beating and you stop breathing. This is often referred to as a Do Not Resuscitate (DNR) order. Some people want to be clear about this choice because they wish to avoid being hooked up to multiple machines such as ventilators in the event of an emergency.
Others might choose to receive every possible medical intervention in the event of a life-threatening situation and will state this choice in their living will.
It's important to note that in most situations, in the absence of other directives, every life-saving effort is made on an individual if they're brought to the emergency room or if an ambulance is called. Therefore, particularly if this is not your choice, it's important to communicate this to your healthcare power of attorney and put it in writing. Some states and even counties have one specific DNR form that they will honor; it may require the person's signature, the physician's signature and signatures of two witnesses to ensure that your wishes are legally honored.
- Nutrition Wishes
Some people choose to avoid having a feeding tube inserted if they are no longer able to take in any nutrients. Others wish to specify under which circumstances they'd want surgery to have a feeding tube placed and when they would want to have it removed.
- General Philosophy Regarding Medical Care and Quality of Life
Some living wills have different options listed to allow you to choose which choice most accurately reflects your preferences. For example, you might be offered the following choices:
- I wish my life to be prolonged through all reasonable means.
- I do not wish my life to be prolonged if I have an irreversible condition that will result in my death within a relatively short time or will cause me to lose consciousness and not regain it.
If neither of the pre-printed options accurately reflect your wishes, you can usually choose to write in your own statement that specifically describes your desires for medical care.
- Pain Relief
Many living wills also clarify wishes about pain relief. This is because people often want to ensure they'll receive adequate treatment of pain even if it may hasten their death.
- Organ/Body Donor Status
Some living wills offer the option of choosing to donate specific part(s) of the body or the whole body for research purposes.
Does an Attorney Need to Draw Up a Living Will?
All states vary in their requirements for, and acceptance of, living wills. The majority of states have information on their websites that outline their regulations and requirements, and many have links to free forms to use for a living will that you can use without an attorney. You might still wish to use an attorney even if your state does not require it if you have further concerns or questions, or if there are extenuating circumstances.
**Please note that many states differ in their specific requirements for a living will. Therefore, it is imperative that you consult your state's legal requirements. The information included on this website and linked to both on and from this site is opinion and information. While I have made every effort to include accurate and complete information, I cannot guarantee it is correct. Please seek legal assistance, or assistance from State, Federal, or International governmental resources to make certain your legal interpretation and decisions are correct. This information is not legal advice and is for guidance only.**
California. Advance Healthcare Directives Form. Accessed August 30, 2012. ag.ca.gov/consumers/pdf/ProbateCodeAdvancedHealthCare
Cleveland Clinic. Advance Directives. Accessed August 30, 2012. http://my.clevelandclinic.org/patients-visitors/legal-ethical-decisions/personal-medical-decisions/advance-directives.aspx
Conneticut.gov. Your Rights To Make Health Care Decision; A Summary of Connecticut Law. Accessed August 29, 2012. www.ct.gov/ag/lib/ag/health/yourrightstomakehealthcare
Illinois Guardianship and Advocacy Commission. Guardianship Frequently Asked Questions. Accessed August 30, 2012. Guardianship Frequently Asked Questions
Massachusetts Medical Society. Important Differences Between Health Care Proxies and Living Wills. Accessed August 30, 2012. http://www.massmed.org/AM/Template.cfm?Section=Home6&TEMPLATE=/CM/HTMLDisplay.cfm&CONTENTID=10979
Michigan.gov. Patient Advocate Designation. Accessed August 29, 2012. www.msu.edu/~betz/estateplanning/2004%20EstatePl
New York State. Department of Health. Medical Orders for Life Sustaining Treatment (MOLST). Accessed August 30, 2012. http://www.health.ny.gov/nysdoh/ems/policy/08-07.htm Texas Medical Association. Medical Power of Attorney. Accessed August 29, 2012. http://www.texmed.org/Template.aspx?id=65
Virginia State Bar.An Agency of the Supreme Court of Virginia. Healthcare Decisions Day. Virginia Advance Directives. Accessed August 30, 2012. http://www.vsb.org/site/public/healthcare-decisions-day/