Thinking about the end of life isn’t comfortable. It’s a sensitive topic to think about and also discuss in articles like this one. Sharing information related to aging is a big part of what we do here at LTC News, though, and that requires tackling tricky subjects at times.
It’s this same discomfort that creates issues when proper preparations aren’t in place to manage assets and end-of-life wishes.
Are you prepared? You may be years or even decades away from having to seriously consider end-of-life decisions. However, that doesn’t mean that you shouldn’t be planning ahead to ensure peace of mind for yourself and your family.
Living wills are one of the ways you can do this. This article will walk you through what living wills can cover, and how to begin preparing a living will.
We’ll also place living wills in the context of advance care planning, which includes more than just living wills, which are only part of the equation of planning for your later years.
Lastly, we’ll discuss the differences between living wills and advance directives. There are some similarities, but these same similarities can create confusion for some about what they cover and when they’re needed.
By the end, you’ll have some considerations and resources to get started, but any creation of a living will should be done in counsel with a legal representative who can guide you through the particulars of living will creation.
What Is a Living Will?
A living will is a written legal document that outlines your decisions regarding medical care to keep you alive. What treatments you would and wouldn’t approve can be included. The living will acts as a decision proxy when you’re unable to make your own decisions due to various forms of incapacitation.
Additional medical decisions regarding end-of-life care, such as whether or not you’d be willing to have your organs donated, can also be included in a living will.
While this seems fairly straightforward, the considerations can sometimes become quite complex. What if a treatment exists but it’s more experimental and isn’t covered by insurance? How long are you willing to extend your life?
These are among the challenging questions you’ll be asked to consider, and the answers may not always be straightforward.
Living Will vs. Will
Living wills are specific to medical decisions when you’re unable to make them yourself. A will is a document that dictates the management of a person’s assets after their death.
If you’ve ever seen a movie in which a will is being read after the death of a family member, it’s not a living will but one detailing the management of things like financial assets or property.
Both can be prepared by an individual, but they’re non-overlapping in what they cover.
Advance Care Planning
Advance care planning is a broader term that covers a variety of planning types related to medical care.
Living wills are considered part of advance care planning. Dictating power of attorney for medical decisions can also be included. Additionally, advance directives can be created by an individual. These differ from living wills. We’ll discuss the key differences in a moment.
As expert sources on advance care planning state, and we’ll happily echo, planning for advance care is not just for those who are older or terminally ill. In fact, these planning steps are easier and less fraught with stress
What Does a Living Will Cover?
Living wills primarily cover medical treatments to keep you alive. Other medical decisions are not included in living wills, though they can be included in other documents such as advance directives.
The types of decisions that can be dictated through a living will can include the following:
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Use of ventilators to maintain life
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Use of CPR techniques
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Use of feeding tubes if you’re unable to feed yourself
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Stipulations based on whether or not the illness or condition is considered terminal or treatable
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A maximum length of time to employ such means to maintain life
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Dialysis for maintaining blood health
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Palliative care that can aid in pain mitigation
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Specific medications that are allowable or forbidden
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Donation of organs or one’s entire body in case of death
These are some of the more common types of direction in living wills, but not the only ones. Speaking with your doctor or other trusted medical professional is advised before including stipulations on any of these in a living will.
If you’ve ever heard the acronyms DNR or DNI, either in a life-or-death situation or perhaps a medical drama on television, they stand for Do Not Resuscitate and Do Not Intubate. These are related to instructions relayed by the patient at some previous point via living will or advance directive.
Medical Power of Attorney
Living wills don’t cover medical power of attorney, sometimes also called a health care proxy. While you can dictate numerous medical decisions with a living will, if you want to appoint a medical power of attorney in case you are incapacitated, it will require separate documentation.
State-based application processes apply for medical power of attorney distinctions. Reviewing your state’s requirements is the first step in preparing this documentation.
Medical power of attorney is an assignment that allows someone else to make medical decisions on your behalf if you’re incapacitated or otherwise unable to make the decisions yourself.
This confers legal authority to your proxy. A proxy can be appointed in addition to preparing a living will, but their decisions may conflict with those on your living will.
Living Will vs. Advance Directive
A living will is a specific type of advance directive. However, advance directives can cover areas not related to emergency care to save someone’s life, making their potential scope a bit more broad.
The easiest way to think of the difference is that living wills cover only treatments related to the end of life, whereas advance directives can include nearly any decision related to medical and health care for which you may need directives if you’re unable to make the decision yourself at some point.
Additionally, you can create more than one advance directive to cover different situations. Conversely, you may only have a single living will. If you want different or additional directives in a living will, you would have to alter the existing will, whereas you can create supplemental advance directives that cover different decision types.
Do Advance Directives Have to Be Followed?
The answer to this depends partially on state requirements, which is why looking up state limitations and laws surrounding advance directives and living wills is one of the first steps in creating your own.
For example, some states require that an advance directive be notarized before they are enforceable. States also generally have state-specific forms for advance directives, requiring knowledge of your state’s guidelines before creating one.
This also means that some states will only accept directives from other states with similar stipulations on their creation.
The wording used by the National Institute on Aging is that advance directives are legally recognized but not legally binding. This means they’re enforceable except when the request is unable to be completed.
As such, you can be reasonably certain that an advance directive will be followed, at least insofar as your health care provider is able to do so.
Consequences of Not Preparing a Will
Whether your wishes are documented in an advance directive or living will, the consequences of not preparing one are similarly risky. Here are a handful of potential consequences:
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Anxiety for your loved ones in making medical decisions on your behalf.
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Confusion over decision rights in emergency situations.
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Delayed medical care as a result of having to consult with others instead of a living will.
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Medical treatment that clashes with personal or religious beliefs.
Avoiding these outcomes is perhaps the best motivator for creating a living will years or even decades in advance.
Someone might also rightly question the validity of creating a living will years before it should be needed. To this, though, there are two possible responses:
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Creating a living will early prepares for the unexpected.
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Most advice on living wills recommends revisiting them periodically to update them with any new information you’d like it to include. This can also account for new medical procedures or treatments that didn’t exist when the will was first created.
Steps for Preparing a Living Will
Before we leave you, we want to make sure you understand what your next steps should be if you’re prepared to create a living will or advance directive. The recommendations and links below will help give you additional considerations and resources that will give you confidence as you prepare these important documents.
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Reflect on the types of medical decisions you would like to have made in the event that you cannot make them yourself.
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Consult with a physician on the creation of a living will or advance directive covering end-of-life treatment and decisions.
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Choose someone you’d want to delegate power of attorney to, and confer with them on your wishes.
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Gather information for your state on living wills and advance directives. The easiest way to do this is to contact your state’s Attorney General’s office or locate a local Area Agency on Aging. You can also download state-based advance directive forms online.
Being prepared means taking action before decisions are forced upon you. Creating peace of mind via a living will is possible for anyone, ensuring that their medical care decisions are handled in ways that match their values and wishes.
Being Prepared as You Age
At LTC News, we help to prepare people for retirement through a variety of strategies. A living will can be a great way to ensure consistency in your medical care, but it alone won’t prepare you for all of life’s long-term care challenges.
Long-Term Care Insurance policies can also reduce the stress on you and your loved ones. They ensure that you have financial protection against the steep and escalating costs of long-term care.
If you’re interested not just in the decisions in a living will, but ensuring that you’re financially prepared to respect those wishes, speak to one of our Long-Term Care Insurance specialists today to get guidance on how you can fully prepare for long-term care security.
