When thinking about end-of-life issues like making a will or
avoiding probate, also consider making a plan for how you want to die. While
some deaths are quick and optionless, chances are good that you will be able to
weigh in on many important decisions -- that is, if you have a plan, and if the
people caring for you know about your wishes.
Your Options for Dying
You may not be able to control what causes your death, but you
may be able to make a meaningful impact on your experience of dying. For example, if your death is at all
foreseeable -- by a few hours or a few years -- you may be able to make
- Where you
die. Do you want to spend your final days in a hospital, at home, in
nursing home, at your child’s home, or another location?
- Types of
medical treatment to receive. Would you like to receive every medical
option available to treat your illness? Are you open to experimental treatments? Or would you like treatments
that focus on reducing your pain, rather than treating the cause of the illness?
your life or hastening your death. If
death is near, do you want your life prolonged as long as possible? Or would you like to allow your body to die
naturally, without intervention? Perhaps
you would even like the option to hasten your own death if your quality of life
has declined to the point at which you would no longer want to live.
control. Are there certain drugs you would not take, or other drugs that
you definitely would choose to take if it were an option? If you had to choose between being lucid and
being pain-free, which would you choose?
- Who will take
care of you, medically and personally. Do you have a personal physician
that your treating physicians should consult? Would you prefer to be cared for by a nurse at home? If it’s possible, is there a loved one who has
offered to care for you at home?
- Who will
make health care decisions on your behalf. If you can no longer make your
wishes known, who should make medical decisions for you?
Chances are that your death will be foreseeable enough for you
to be able to make some of these decisions, if you make a plan. (For a discussion about types of death and
their likelihoods, see The
Reality of Dying, by Bill Simmons of www.finalexodus.org.) If you do not leave instructions about how
your death should proceed and if your condition keeps you from being able to
make your own decisions, medical professionals and family members will likely
decide many of these issues for you. Keep in mind that under the oaths of their
professions, medical professionals must do everything they can to keep you
alive, unless they have a clear (and legal) directive to do otherwise. Further,
without planning, the court system may need to step in to make legal decisions
for you -- like appointing
someone to act on your behalf.
Planning and Documenting Your
The most accepted (and arguably, effective) way to plan and convey
your wishes is to use a combination of health care
directives -- most commonly, a living will and medical power of attorney. A
living will allows you to document
your wishes for health care and a medical
power of attorney appoints a trusted person to make health care decisions
for you, if you cannot make them yourself. Different states use slightly different
names for these documents (and many combine these two documents into one),
and the finalization
requirements vary as well. But in every state, health care directives serve
the same purpose -- to put your wishes in writing and to legally require your
wishes to be followed.
As you make your documents, you will face many personal
decisions. Thinking about the issues involved may be difficult, even if your
choices are clear. If you have questions, consider consulting your doctor, lawyer,
or spiritual advisor.
Here’s where to look for a health care directive:
- local senior centers
- local hospitals
- government websites (many states have their own “statutory”
- your state’s medical association, or
- online – many options, for example from Caring
Connections or www.finalexodus.org.
You can also make a living will and health care power of
attorney using Quicken
WillMaker Plus. This software comes with a traditional will, durable
power of attorney for finances, free access to Nolo’s online living trust, and
many other useful forms.
Learn more about making Living
Wills & Medical Powers of Attorney on Nolo.com.
Talking to Your Love Ones
Perhaps even more important than making your health care documents
is talking to your loved ones about your wishes. You’ll want to talk to those who will be
close to you at the end of your life, as well as those who may be called on to
make decisions about your health care, living situation, or finances.
Having clear and direct conversations about your end-of-life
wishes may be difficult, but doing so will help ensure that:
agent understands your wishes. If
you choose to make a durable power of attorney for health care, you will
appoint an agent who will make medical decisions for you if you cannot make
those decisions yourself. It’s vital
that your agent understands your wishes because it is your agent’s job to
convey those wishes to the people providing care to you. And while it’s a good
idea to document your wishes in a living will, having a personal conversation
with your agent will clarify what you want and also provide an opportunity for your
agent to get a deeper understanding of your wishes. You don’t want your agent to have to rely on your
living will for this understanding because there may be times when he or she
needs to make choices without that document in hand.
- You will
get the right care in an emergency. Sometimes, and often in an emergency,
doctors don't have time to find, or even read, your living will. Instead they turn to the relative who is
standing nearby to discuss the treatment options. This relative, whomever it
might be, needs to understand your wishes. So to ensure that everyone who might
end up in that situation understands your wishes, have real conversations with each
of your family members.
- No one will
be surprised by your choices. The
time to head off controversy surrounding your end-of-life choices is long
before the choices need to be made. Make
sure that everyone who might be involved with this stage of your life -- spouses, adult children, physicians, or clergy -- understands your wishes. That way, when your
choices are followed, there will be no question as to what you wanted. Have this conversation even if you make a
power of attorney and a living will that explains your wishes. A personal conversation will go far to smooth
over any concerns. And making sure that everyone is on the page will take some
pressure off your agent, who will have the weighty job of making sure your
wishes are followed.
If you’re having trouble talking to your loved ones about
these issues, you’re not alone -- it’s not easy. Look for support in your community or online. For example, here are some resources
suggested by Death Café, an organization that
supports and promotes real and honest conversations about death. For more about talking with loved ones, read Conversations