Without an Advanced Directive, You Could Receive Unwanted Treatment
Also known as a living will, the document can save family horrible grief
Most Americans remain stubbornly indifferent to putting down in writing what kind of medical care they want if they are ever unable to convey those wishes themselves.
Fifteen years ago, a Gallup survey revealed that just 40% of American adults had a living will, which is also referred to as an advance directive.
This May, smack dab in the midst of a deadly global pandemic, a fresh Gallup survey finds just 45% of Americans have a living will. Women (47%) are slightly more on the ball than men (42%.)
To be clear, a living will is not a will. The latter is a document that can be helpful for your family to sort through inheritance issues after you die. A living will is all about how you want to be cared for while you are alive, but not able to make your wishes known.
It’s important for the young, too. Accidents and strokes can leave anyone unable to communicate or navigate treatment options.
And it is so vitally important to have a living will in place as we age. One of the most compelling reasons to have a living will: cognitive decline.
An estimated 5.8 million people in the United States currently have Alzheimer’s related dementia, and that count is expected to double by 2040. That’s just for dementia specifically caused by Alzheimer’s and does not include other forms of dementia.
We can all hope our minds stay sharp and our voices strong. But that guarantees nothing. You’ve bought all types of insurance your whole life to protect yourself. A living will is another form of protection (and this one is free). It ensures you will only get the care you want, and be spared what you don’t want:
It’s not just about you. Do you care about whose lap the decision-making may fall into if you don’t have a living will and you become unable to advocate for yourself?
In the recent Gallup poll, one in four adults said they had to step in and make these hard decisions for a loved one. Are you seriously OK imposing that on someone else? C’mon. A living will/advance directive will give family or a friend the road map to care for you, and not leave them saddled with doubts, if not guilt, that can linger for years after you pass.
It’s free. No lawyer needed. If cost and hassle is your roadblock, consider your road cleared. You can download a free advance directive/living will that is legitimate in your state at the website of the National Hospice and Palliative Care Organization.
A web search for “advance directive dementia” will land you at a site where you can download a free document that will guide you through spelling out your care preferences if at some point dementia enters your life.
Once you are cognitively impaired, you likely won’t fully understand treatment options, or be able to clearly express what you do/don’t want. The time to spell that out is now. As is whether you want to stay at home, or be hospitalized, at a point where you are very ill.
Be as specific as you want. Living will documents will walk you through potential scenarios so you can weigh in on the level of care you want or don’t want. This can cover everything from your wishes regarding resuscitation, intubation, medication and whether you want to be supported by feeding tubes. In some states, you may have already been prompted by your primary care doctor to lay down your wishes regarding Do Not Resuscitate (DNR) or Do Not Intubate (DNI) orders.
It’s easy to validate. Once you have created a living will, each state has its own rules on whether you need to have a witness (or two) watch you sign the doc, or whether a notary is required. The nolo.com website has a directory of state rules for signing docs. (A web search of “nolo.com finalization advance directive” will get you there.)
Once you have the document signed, make sure it gets in the hands of the right people. You want it on file with each of your doctors, and give a copy to at least one family member or friend.
Ideally, you’ll be up for creating an additional document that is an important complement to your living will. With a healthcare power of attorney (sometimes called a medical power of attorney) you name someone you trust to make decisions for you if you’re ever unable to advocate for yourself. The person you appoint acts as your “agent,” making sure your caregivers follow the directions you’ve laid out in your living will/advance directive.
If you are finally ready to tackle all the important planning documents, the healthcare power of attorney is going to be part of any package a lawyer will draw up, along with a will, durable power of attorney for finances, and possibly a living revocable trust. That said, you can find online services that offer healthcare power of attorney forms for free, or for as little as $50.