The first essential estate planning document we’re covering in this series is advanced directives. These are instructions for all aspects of your medical care if you are unable to make decisions for yourself. People have different ideas about how they want the end of their life to be and it’s nice for you, and your family, to make your wishes known. Creating an advance directive makes sure your preferences for your health care are followed and saves your family from having to make the decisions without knowing what you would’ve wanted.
There are two main parts to a well-drafted advanced directive: 1) naming a medical power of attorney and 2) expressing your decisions regarding end of life care and organ donation. You can have a separate living will, which lays out your health care wishes or a separate medical power of attorney but having it all included in one document can be more effective.
Many states offer a free advance directive, living will, or medical power of attorney. Check the Attorney General’s office for your state to see if one is available. They’re usually pretty basic and may or may not include all of the items in this article, so that’s something to look out for.
Advanced directives have different signing requirements depending on your state. Some require two witnesses and/or a notary. Check the requirements for your state by searching “advance directive requirements [your state]”
Naming a medical power of attorney
One thing that needs to be included in your advanced directive is naming a medical power of attorney. Your medical power of attorney is a person you designate to make medical decisions on your behalf if you’re not able. And, they can only make decisions on your behalf if you are unable. You can name a spouse, family member, or friend. It’s always a good idea to include at least one alternate.
These are called different names depending on your state. Some names include health care proxy, health care agent, health care surrogate, health care representative, health care attorney-in-fact, patient advocate. If you call it by the wrong name, it will probably still be valid as long as your intentions are clear.
Who should you choose?
You cannot name your doctor as your medical power of attorney. You don’t necessarily have to talk to your medical power of attorney ahead of time about your wishes, but if you do it will make their job a lot easier. It needs to be someone who is comfortable making difficult decisions and willing to serve as your advocate if there are disagreements about your care.
The living will is the part where you decide how you want your end of life care to be. This is where you lay out your wishes regarding what treatments you want to receive to keep you alive. It also includes things like pain management and organ donation. There are no right or wrong answers, and it’s a very personal decision. I’m a strong advocate for organ donation, but some people are not comfortable with it and that’s ok.
Some things to include are:
- Life-prolonging treatment
Do you want to be on life support or allowed to pass naturally? Do you want artificially provided food or water?
- Organ donation
You can say you’ll donate all of your organs or none of your organs. Or, you can get specific about what you’re willing to donate and what you’re not.
What do you need to do with your advanced directive
- Make copies
Give a copy to your doctor and medical power of attorney. Make extra copies in case you need to go to the hospital or require some other kind of emergency care. Providers generally like to have these on file.
- Keep the original in a safe place
It should be somewhere that is easily accessible. Be careful about using safety deposit boxes. A court order is usually required for a non-owner to access a safety deposit box, so it can take some time before your
- Talk to the people in your life
Discuss your values and what’s important to you when it comes to medical and/or end of life issues. This is not always easy to talk about and the people in your life may be hesitant, but it’s important for your family to know your wishes.
- Take a copy with you if you travel or have to go to the hospital or other medical institution
If you could possibly receive medical care from anyone other than the doctor or hospital that already has your advanced directive on file, it’s important to remember to have a copy with you for the new medical team.
These documents can be changed at any time by creating a new form and destroying the old one. If you want to make changes, make sure you follow the steps above in regard to the new advanced directive you create—make copies, keep original in a safe place, and talk to your family about your wishes. Some reasons you may want to change your advanced directive include:
- Marriage or divorce
- New medical diagnosis
- Death of a previously named medical power of attorney
Having an advanced directive that includes your wishes regarding end of life care, organ donation, and a named medical power of attorney is so important to let your health care providers and your family know what you want to happen in case you aren’t able to make these decisions for yourself.