You may have heard the terms living will or advanced directive, and wondered just what they mean. Simply put, it’s a legal document specifying what actions you want taken related to your health, if you’re incapacitated or otherwise unable to communicate your decisions to your health care providers directly. It’s really something you ought to make time to do, and a copy should be provided to your regular physicians. It’s a good idea to make a card listing their names and phone numbers to keep in your wallet. In the event you are unexpectedly hospitalized, your physicians can be contacted and will be able to provide a copy of your living will/advanced directive, as well as information on your medical condition and any medications you’ve been prescribed.
What’s the difference between the two? Generally, a living will spells out what measures you want taken to save your life, or treatments offered to you in the event you’re unconscious or incapacitated and can’t discuss your medical choices with your doctors. You can be as specific as you want, so it’s best to give it some thought. Some people choose to be “DNR” or Do Not Resuscitate. This means if your heart stops beating or you stop breathing, the medical team will not attempt to “bring you back”, and will allow nature to take its’ course. “Full Code” means you want all available steps taken to restart your heart or breathing. Some people don’t want to be on a ventilator, which is a machine that breathes for you. Others have specific instructions for scenarios where they would or would not accept being on a ventilator, temporarily or permanently. Sometimes it’s not easy to know or explain what you might want. Talk to family members and even your physicians about your choices and any areas you’re not sure of. It’s your life and you do have the option to choose the treatment offered to you, or even choose to have treatment withheld. Understandably, this can be a difficult choice for your spouse or children to make, even if you have talked with them about your preferences. While doctors will attempt to include them in the process to the extent they’re able, if you have a living will, that’s the final authority. They are, however, somewhat limited in that they don’t cover all situations. If your condition or the proposed treatment falls into a grey area, the living will won’t be much help.
An advanced directive is a legal document much like a power of attorney, giving permission for a named individual (your “proxy”) to act on your behalf and make medical decisions for you, in the event that you aren’t able to. Advanced directives are a bit more flexible in allowing your proxy to listen to the facts and opinions presented by the medical team, and make the determination they feel is in your best interest or that coincides with your wishes. It can also be revoked if you recover. It leaves all the responsibility on your proxy to decide what care you will or will not receive, so it’s imperative that you have a serious, in-depth discussion with this person and be quite clear with your wishes.
Many people combine the two and have both a living will and an advanced directive. This can be very beneficial since the living will can very clearly state your wishes with regard to resuscitation, ventilation, and feeding tubes. The advanced directive will give your proxy the ability to make decisions in those grey areas that aren’t clearly spelled out in your living will. Make sure family members know your decisions and that you have a living will and/or an advanced directive. They may disagree or have questions, and the time to have that conversation isn’t when you’re hospitalized for a serious injury or illness.