Here are some tips for creating a living will.
First, a living will is a written, legal document that spells out medical treatments you would and would not want to be used to keep you alive, as well as other decisions such as resuscitation or organ donation.
Here are some possible end-of-life care decisions in your living will:
- Mechanical ventilation takes over your breathing if you’re unable to do so.
- Tube feeding supplies the body with nutrients and fluids intravenously or via a tube in the stomach.
- Dialysis removes waste from your blood and manages fluid levels if your kidneys no longer function.
- Antibiotics or antiviral medications can be used to treat many infections.
- Comfort care (palliative care) includes any number of interventions that may be used to keep you comfortable and manage pain, while abiding by your other treatment wishes.
- Organ and tissue donations for transplantation can be specified in your living will.
- Donating your body for the scientific study also can be specified.
- Resuscitation restarts the heart when it has stopped beating.
Do not resuscitate and do not intubate orders
However, you don’t need to have an advance directive or living will to have do not resuscitate (DNR) and do not intubate (DNI) orders. Make your preferences known to your physician, who can write the orders and put them in your medical record. Again, check with attorneys and your doctor.
Creating advance directives
Advance directives need to be in writing. Links to state-specific forms can be found on the websites of the American Bar Association and the National Hospice and Palliative Care Organization.
Keep a copy in your safety deposit box as well as with your health care files.
- Give a copy to your doctor, health care agent and any alternate agents.
- Keep a record of who has your advance directives.
- Carry a wallet-sized card that indicates you have advance directives, identifies your health care agent and states where a copy of your directives can be found.
- Keep a copy when traveling.
Physician orders for life-sustaining treatment (POLST)
In some states, advance health care planning includes a document called physician orders for life-sustaining treatment (POLST). The document may also be called provider orders for life-sustaining treatment or medical orders for life-sustaining treatment (MOLST). Your doctor fills out this form.
A POLST is for people who have been diagnosed with a serious illness. This form does not replace other directives but serves as doctor-ordered instructions — not unlike a prescription — to ensure that, in case of an emergency, you receive the treatment you prefer.
If you are in a hospital or nursing home, the POLST is posted near your bed. If you are living at home or a hospice care facility, the POLST is prominently displayed where emergency personnel or other medical team members can easily find it.
Your doctor will fill out the form based on the contents of your directives, discussions with your doctor about the likely course of the illness, and your treatment preferences.
Issues covered in a POLST may include:
- Mechanical ventilation
- Tube feeding
- Use of antibiotics
- Requests not to transfer to an emergency room
- Requests not to be admitted to the hospital
- Pain management
A POLST also indicates what advance directives you have created and who serves as your health care agent.
Your attorney should retain copies and as I mentioned earlier, I would also suggest storing in a safe or a safety deposit box or file.
Do you have a living will? Do loved ones know where your living will is and can they easily access?
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