Once a year, on or around National Healthcare Decisions Day (the day after tax day in the US), I take a minute to review my living will and other advance care directive paperwork. Advance directives, sometimes called healthcare or medical directives, are the documents that direct and enable your care in case of incapacitation or at the end of your life.
When I first learned about estate planning, I found some of the vocabulary confusing because often terms are used interchangeably, and sometimes I wasn’t sure if the term referred to a person or a piece of paper or a process. So this advance care planning "cheat sheet" covers the basic terms and shares what I think are some of the best end-of-life planning resources. I also share what's in my own living will!
Advance Care Planning Terms
A collection of documents that outline end-of-life priorities, and assign someone to speak and act on your behalf if necessary.
Healthcare Power of Attorney
A document that designates a person, sometimes referred to as a healthcare agent or proxy, to make decisions for you in case you are not able.
Healthcare Proxy or Agent
The term used to refer to the person named in your healthcare power of attorney document. Confusingly, sometimes people will say “your healthcare power of attorney” to talk about the person (your agent.)
A document that gives your healthcare proxy guidance on what kind of care you want (and don’t want) at the end of your life (or if you’re permanently unconscious.)
DNR or POLST
A Do Not Resuscitate or DNR order is a medical order (a document) that emergency and hospital personnel that you do not want CPR if your heart stops beating. A POLST is a Physician Order for Life Sustaining Treatment and it states your preferences for a variety of medical treatments (where a DNR only covers your CPR preference.)
Organ or Tissue Donation
Your advance directives can also include your preferences for organ or tissue donation, and related documentation (for example, if you’d like to donate to a specific institution, or have registered with a specific state’s organ donation program.)
Advance Care Planning, on the other hand, refers to the process of understanding what options exist and forming an opinion. Sometimes that’s harder than filling out the paperwork. Here are my choices for the best resources for advance care and end-of-life planning:
- National Institute of Health has great information on advance care planning that can help you think through decisions that might come up.
- Compassion & Choices provides a free End-of-Life Decisions Guide & Toolkit. Their site also has links to legally valid, free advance directive forms for every state.
- The Conversation Project offers conversation guides in multiple languages, including a specialized guide designed to help families and loved ones of people with Alzheimer’s disease or another form of dementia diagnosis. Use these to prepare for conversations with your doctor and the person you’d like to be your healthcare proxy.
Taking steps to anticipate your own inevitable death can be surprisingly rewarding. In my case, it was also a little bewildering at first. What do I want?
This is what my own living will says this year:
Death is as much a reality as birth, growth, maturity, and old age. It is the one certainty of life. If the time comes when I can no longer take part in decisions for my own future, I desire that this statement stand as an expression of my wishes.
If the situation should arise in which there is no reasonable expectation of my recovery from physical or mental disability, I request that I be allowed to die and not be kept alive by artificial means or heroic, experimental, or extraordinary measures. I do not fear death itself as much as the indignities of deterioration, dependency, and hopeless pain. I, therefore, ask and direct that medication be mercifully administered to me to alleviate suffering even though this may hasten the moment of my death.
Disclaimer: this is not a legal document, nor is it legal advice.
Maybe this isn't what I'll always want it to say. But it feels right today, and a year from now I’ll be reviewing it again!