Why All Adults Should Have a Living Will

What to include in your living will

In general, your living will should have:

• A standard direction that you do not want life-prolonging procedures administered or continued if there is no probability of your survival.
• More specific directions about what care you do or do not want (for example, dialysis, mechanical ventilation to assist with breathing, artificial hydration and nutrition or CPR).
• Anatomical gift decisions (meaning whether you wish to be an organ and tissue donor or donate your body to science or education).
• Palliative care wishes (such as whether you wish to die at home or avoid invasive tests or procedures).
• Spiritual and religious considerations (your faith may have its own directions for how to create a living will).

Some people are concerned that doctors will not provide medical care if they have a living will. Remember: This is intended only to be an end-of-life document. It does not prevent routine medical treatment or care for conditions that are not life-threatening.

Your living will is not a script. One document can’t anticipate every possible scenario and dictate exactly how things will go.

Consider it more of a conversation (and that conversation may change, because your feelings about death may be different when you’re in good health than after a diagnosis of a terminal condition or debilitating disease).

How does a living will differ from a DNRO?

A Do Not Resuscitate Order (DNRO) is a doctor-created document that directs medical providers (EMTs, hospitals or nursing homes) not to attempt CPR if a patient is in cardiopulmonary arrest.  

A living will is more complex. It serves as a complement to the DNRO and can be created at any time. 

If you are seriously ill, discuss a DNRO and physician’s orders with your doctor. 

You may want to discuss documents such as portable medical orders. These go by different names in different states and are sometimes known as POLSTs (Physician Orders for Life Sustaining Treatment), MOLSTs (Medical Orders for Life Sustaining Treatment), POSTs (Physician Orders for Scope of Treatment) or MOSTs (Medical Orders for Scope of Treatment). They tell your providers what treatments you want if you can’t consent to your medical care and are portable — they can be used whether you are in a hospital, nursing home, hospice or at home.

When should you write a living will?

Do not wait until confronted with an illness to create a living will. The unexpected can happen at any time, so write your living will when you’re in good health, but review and update it as needs and conditions change. 

Remember that the doctor-created forms (DNROs and physician orders) will not come into play until you and your doctors agree you need them, when faced with serious illness or advanced frailness.

Where should you keep a living will?

As you put together your documents, talk to your doctors about your wishes. Have them put your living will on file, or consider placing it in a registry.

Speak with your closest family and friends, particularly those who may be your caregivers one day, so they know what your wishes are, and provide them copies of the living will.

Having these talks and writing your living will ensures that you live according to your own terms until your last breath, while giving your loved ones a sense of peace when it matters most.

Where should you keep your DNRO?

Emergency personnel need to be able to find a DNRO and other documents if you have a life-threatening event. 

Patients are advised to put such documents on their refrigerator or in their medicine cabinet if they live at home. Keep a copy in your purse or wallet as well. If you reside in a facility or are hospitalized, there should be a copy in your file.

Editor's note: This article published on Aug. 14, 2019, has been updated with a new section on DNROs by the writer.