Advance Directives: End of life on your terms

Three documents, three benefits—and three reasons we avoid them!

There are three types of documents that inform others of your decisions for care at the end of your life. A health care directive, or living will, specifies what care you want at the end of your life. It’s used only if you’re unable to communicate for yourself. In a durable power of attorney for health care, you name a person as your agent and authorize them to make medical decisions for you if you’re unable to do so yourself. The Physician Order for Life-Sustaining Treatment (POLST) is a short document that’s useful in an emergency, informing emergency personnel of what care you do and do not want.

What are the benefits of having these documents?

  1. Makes sure your wishes are carried out. If there are procedures you don’t want, or if you wish to be allowed to die naturally, advance directives greatly increase the likelihood that your wishes are followed. With no documents, medical providers will do everything possible to extend your life.
  2. Avoids burdening family with difficult decisions. Your family will know that they are honoring your wishes. They can avoid feeling guilty or that they’ve harmed you by withholding unwanted procedures.
  3. Prevents unnecessary suffering. CPR is traumatic and invasive. Afterward, some may be much less able to have a good quality of life.

Why don’t more people create end-of-life documents?

Death is an uncomfortable topic—that’s the main reason we avoid this task. Yet the benefits of advance directives far outweigh our discomfort. Sometimes expense is a concern, however document creation needn’t be expensive. You don’t need an attorney, and forms are available online and through local agencies. Finally, many wait until it’s much too late. It’s better to define your choices when you’re healthy and can discuss them with loved ones.

As a doctor, I see the benefits of end-of-life planning in action when I work with prepared families. I encourage you to make an appointment with your primary care provider, who can help you approach this difficult but empowering task.