"For the past few years, I've made a habit of giving advance directive forms to all of my new patients," says Dr. Karen R. Myers of Washington, D.C. "These are legal instructions everyone should take the time to complete.
"Myers, a doctor of Internal Medicine, knows firsthand the pain families suffer when terminal patients leave no care instructions. "I had a patient in his 40s who came into the hospital with pneumonia and meningitis," she says. "He turned out to have AIDS and just got sicker and sicker. Eventually, he slipped into a coma, and we pronounced him brain dead. But because he didn't have an advance directive, his family struggled with the decision of whether to let him go. Finally, after two months on life support, his poor body just couldn't take anymore. If the patient had made his wishes known in writing, his family could have been spared some of the heartache of losing him."
To keep this from being your own scenario, create a road map for your loved ones to follow. Put your desires in writing by completing three important documents: a living will, a health-care power of attorney, and a letter of instruction.
Why Create a Road Map?
Developing a road map keeps you in charge when it comes to decisions about medical treatment—even when you’re no longer capable of making those decisions. This kind of planning also shows compassion for family and friends. When loved ones are left guessing, too often the result is guilt, uncertainty, and arguments. By making your wishes known, you can help your loved ones feel more comfortable with your chosen course of care.
Parents' decisions about their own care usually, at some point, involve their children. When you complete your own advance directives, you have an opening to talk with your parents about whether they've made choices about their future medical care. Starting the conversation and learning what care they want can give the whole family peace of mind.
"I'm fortunate that my mother approaches me about her needs," says Carrie Dunson of Lee's Summit, Mo. "After my stepfather died in 1989, my mother and I sat down and talked about what she wanted as she grew older. We had our wills and advance directives drawn up at the same time and discovered that we want very different things. In the event of a coma, she wants doctors to do everything possible to revive her. But I don't want that for myself."
What Do You Need?
Each of the documents you need for your road map serves a different purpose. The first two—living will and health-care power of attorney—are legal instructions known as advance directives.
A living will tells medical professionals and your family which medical treatments you want to receive or refuse—and under what conditions. It only goes into effect if you meet specific medical criteria and are unable to make decisions.
A health-care power of attorney allows you to appoint someone to make health-care decisions for you any time you're unable to do so. Most people choose trusted family members or friends who are comfortable talking to doctors. The power of attorney can also be referred to as a health-care proxy, an appointment of a health-care agent, or a durable power of attorney for health care. It is different than a regular durable power of attorney, which only covers financial matters.
The third part of the road map—a letter of instruction—isn't a legal document, but it helps families find important information and saves them from having to dig through papers during a crisis. This document is a three-part personal letter that goes with the will. The first part includes the names of people to contact and instructions for planning a funeral. The second part covers financial affairs such as lists of accounts and phone numbers for your employer, insurance agent, or broker. In the final part, you can give away meaningful possessions and write special messages to family members.