Posted on: November 7, 2008

Alive and Will

Many see it as morbid, but the creation of a living will can make the future easier for loved ones

By Jeff Schnaufer
CTW Features

If Michael Kirtland had a magic wand, he wouldn't use it the way most of us imagine.

"If I had a magic wand, I would make people do living wills while they are still healthy," says the Colorado Springs-based certified elder law attorney. "The most common situation is that people are already in the hospital when they are told by the doctor they have a very short life expectancy. That's often where the document gets done. The problem is that you are trying to make important decisions while you are under a great deal of stress."

According to the American Bar Association, living wills are your written expression of how you want to be treated in certain medical conditions. Living wills may also be known in different states as "medical directories," "health care proxies" or "advance health care directives."

Depending on state law, this document may permit you to express whether or not you wish to be given life-sustaining treatments - including heart-lung machines and ventilators - in the event you are terminally ill or injured, to decide in advance whether you wish to be provided food and water via intravenous devices ("tube feeding"), and to give other medical directions that impact the end of life.

A 2007 survey by Harris Interactive for Martindale-Hubbell's lawyers.com. found that living wills have jumped in popularity since 2004. About two in five adults (41 percent) now have living wills in place, a full ten percent higher than just three years ago.

Healthy young people seem to have an easier time creating a living will, Kirtland says.

"I get young people in my office and they do these documents in a matter of minutes and don't even think about it. It's sort of an abstract concept to them," Kirtland says. "But when I get older people in my office with a serious or terminal medical condition, it becomes very personal and the decision seems to be much more difficult because they are really facing this situation."

Yet the absence of a living will can have an immense impact on your family when tragedy strikes, experts say.

"Think of Terri Schiavo and the fight that ensued because she'd never stated her wishes for end of life care," says Liza Hanks, an attorney in Campbell, California and author of "The Busy Family's Guide To Estate Planning" (Nolo, 2007).

Experts suggest the following three tips for creating a living will:

1) Consult with someone who knows state laws on living wills. "It doesn't have to be a lawyer," Kirtland says. "It could be someone at the hospital who knows what state law is on that subject."

2) Read the document carefully and consider your responses. "This is not something you want to do off the top of your head," Kirtland says. You want to be able to answer while in a healthy state of mind if you want life sustaining treatment, machines, surgeries, etc.

3) Talk to loved ones. "Tell them what your desires are," Kirtland says. "Talk to them about how you feel about the dying process." Adds Hanks: "I would stress that having the conversation with your family about what you do and don't want is maybe even more important than the document itself."

Keep in mind, Hanks adds, that as long as you are able to communicate you can still direct your own care.

"Living wills and advance directives only come into play when someone can no longer communicate their own wishes," Hanks says. "So people can and do change their minds about what they want when they're actually in a dire situation."

And remember that your decision to create a living will can affect the decisions your family faces in the future.

"Apparently families often feel so conflicted about what to do because they're not sure what their loved ones wanted," Hanks says. "This document can give people peace of mind about terminating life support when that's the right thing to do."