End of Life Decisions

older woman looking somber

The best time for making end of life decisions is before you are in the depths of a serious illness and you are able to think rationally about how you want end-of-life issues to be handled. When this is done early enough, you maintain control of your future and your family and friends are relieved of the burden of making key decisions for you.

There are several things to consider when planning for end of life decisions. To help you put affairs in order, the National Institute on Aging has a lot of good information to help with understanding all that is involved in being sure you have set things up appropriately.

Our Aging Well Resource Coordinator can help you understand your needs and access these resources.

Family Conversations

One of the most important steps in end of life planning is having conversations about end of life decisions with the people in your life. It is important that your loved ones know your wishes and their role in the process.

The Conversation Project is dedicated to helping people talk about their wishes for end-of-life care. They have many resources available online to help you get started and guide the conversation.

happy couple in a park

Advance Directives/Living Will

Advance Directives / Living Wills are specific instructions to selected designees on how you want your health care managed should you become unable to make those decisions yourself. They involve decisions about life-sustaining or life-prolonging treatments such as your preferences for tube feeding, artificial hydration, mechanical ventilation and pain management.

You may also hear this called “a declaration regarding life-prolonging procedures” or simply a “declaration.”

It is important not to confuse a living will with a last will. A last will and testament expresses what you want to happen to your property and minor children if you die. A living will expresses what you want to happen to your person regarding medical treatment while you are still alive.

The Advance Directive forms you need vary by state.  Some Advance Directive forms combine your Living Will and your Health Care Power of Attorney.  You may want to complete a health care power of attorney form as well, separate from the advance directive form. We provide information on these forms in the Health Care Power of Attorney section.

AARP has Advance Directives forms you can download by state. These forms need to be notarized and witnessed by individuals who will not benefit from your estate in order to become official.

Advance Care Planning Tool

There is an organization called Five Wishes that has introduced a relatively new approach to advance care planning. Their process is simple, yet comprehensive and the result is an easy-to-understand advance directive form that is legal in 42 states.

Five Wishes allows you to express:

  • The person you trust to make decisions for you
  • What types of medical treatment you would want – or not want
  • What is most important for your comfort and dignity
  • What important spiritual or faith traditions should be remembered
  • What you want your loved ones and healthcare providers to know about you

Please note that there is a small purchase price to use Five Wishes.<,p>

Do Not Resuscitate (DNR) Order

Resuscitation decisions are usually recommended for terminally ill or very frail elderly individuals. A Do Not Resuscitate order tells emergency personnel to not perform CPR if they are called to your aid. Even if you have instructions outlined in your living will, that document is not considered by emergency personnel once they are called to your home.

There is another form that goes beyond resuscitation instructions. It is called Physician’s Orders for Life-Sustaining Treatments (POLST). In your state, they may be called MOSTs or MOLSTs. These are legal forms signed by your physician and honored by emergency personnel and hospitals in most states. This link provides very comprehensive information on these options. You can learn more about a POLST from DailyCaring.

Health Care Power of Attorney

A health care power of attorney — also known as a durable medical power of attorney or health care proxy — is a person who understands your wishes and who you have chosen to make decisions related to your treatment in accordance with your wishes if you are not able to.

There is a form that must be signed by you and a non-family member witness who will not benefit from your estate. The American Bar Association has a helpful guide and a form that is good in all but five states. In New Hampshire, Ohio, Texas, Wisconsin and Indiana there is specific language that needs to be included. The American Bar Association also has a toolkit for health care advanced planning.

three generations of women

Financial Power of Attorney

A financial power of attorney is a legal designation of someone who can pay your bills and make financial decisions only if you cannot. This designation gives the selected person the ability to make financial decisions only and not health care decisions. It may be helpful to have an attorney or an estate planner help you with these forms as each state may have different requirements. AARP has guidance on powers of attorney that can help you get started.

The American Bar Association also has a tip sheet with safeguards to consider when making power of attorney decisions.

Last Will & Testament

Your will assigns an executor and provides directions on the disbursement of your tangible goods and property. If you have a large estate, it might be a good idea to assign a non-family member as your executor. AARP provides a good tool to help you with decisions about a will and information on the completion of a will.

What My Family Should Know

Planning for the end of life is never easy. Our free What My Family Should Know guide can help make the task a little easier. Print this guide and fill it out with your information. Make sure your document is stored in a secure place your loved ones can access if needed.
woman holding hands with spouse

Final Thoughts

Finally, in understanding the importance of making these decisions, consider some information from the author of Being Mortal, Atul Gawande.  He reminds us that this is fundamentally about what you want and introduces the concept of you defining what a good day is and how you want that to factor into ensuring quality of life.

If you need assistance drafting any of these legal documents, you may consider hiring an attorney, which can be expensive. Compass Rose Benefits Group offers access to affordable legal services through LegalShield. You can have all these documents created for you with your membership and you can cancel at any time.

Remember to give copies of your documents to each family member involved, your designated decision-maker, your doctor and your attorney. Put some copies in a safe place in your home, not in a safety deposit box. Take copies with you whenever you go into the hospital. Review often and update when there are changes.

Get Started

The resources on our site are a good starting point to help develop your aging well plan. Everyone’s needs are unique — that is why we have people you can talk with regarding your individual goals.