Who Will Speak for You When You Can't?
It takes more than a living will. Here's what you have to do.
(MONEY Magazine) – The Terri Schiavo case is exceptional in many ways, but all too common in one: "In 25 years, I cannot count the number of times that families were in disagreement about what was right for the patient," says Don Schumacher, president and CEO of the National Hospice and Palliative Care Organization. The solution, however, is tougher than most people expect. If you hope to lessen the odds of a bedside feud--or worse, not getting all the support you need when it counts most--it's time to speak up. You'll want two documents: a living will and a durable power of attorney for health care. Not one. Both.
"A living will is where you give specific instructions to your doctor," explains attorney Albin Renauer, co-author of Quicken WillMaker. It should address your wishes in case of terminal illness or permanent unconsciousness. You don't want to be kept alive on a ventilator or feeding tube? Say so, and clearly. You want every available measure taken? Write it down.
A durable power of attorney for health care is needed to designate a trusted advocate to ensure your wishes are carried out. This is crucial in unconsciousness cases (like Schiavo's) that start not as end-of-life issues but as long-term-care cases where living wills may not be explicit. You don't give up the right to make decisions for yourself. "It only kicks in if you are incapacitated," says Renauer. "If you can blink your eyes, you're in control."
These documents are legally binding, but you don't need a lawyer to create one. Free forms and information can be found at nho.org, the website of Schumacher's hospice organization (or call 800-658-8898). Quicken WillMaker Plus 2005 ($49) has been updated for every state and walks you through the process of sorting out your feelings. Read carefully: State laws on the format of these documents vary; some must be notarized, others merely signed and witnessed.
Before you fill out any forms, though, plan some heart-to-heart talks--with yourself and those closest to you. Yes, this is the hard part. But it's essential. "Talking helps to clarify what you think you want and lets people know how you want to have decisions made for you," says Nancy Coleman of the American Bar Association. "You don't want one stray comment to define you. Probe more deeply."
While you're at it:
• CONSULT YOUR DOCTOR In a comprehensive living will you'll be prompted to consider everything from pain control and its side effects to which heroic measures, if any, you want taken to prolong life. Your doctor can help you decide what these choices mean for you. Give him or her copies of your living will and power of attorney. By law, a doctor or health-care provider has to make them part of your permanent medical record.
• CHOOSE YOUR ADVOCATE Talk about your wishes, but also discuss his or her role. Can the person make tough decisions? Make judgment calls in an evolving medical situation? Calmly explain your thinking and your medical options to family and friends? A spouse is the typical choice here, but a friend may be a better (or the only) option for some people. Make sure your family knows that your designee has your faith and trust.
• KEEP COPIES Your family or surrogate should know where to find them. You also may want to bring the copies if you're admitted to a hospital. And if you move? All states currently accept a properly completed living will from another state.
• KEEP TALKING Review your directives annually, since your thinking--or your friends or family, or even modern medicine--may change. All the talking may also help you feel closer to the ones you love most. Isn't that what life is all about?