Advanced Health Care Directives and Living Wills: Key Differences and Why They Matter
Have you ever heard someone say, “They died doing what they loved?” I recently heard that about a woman who passed away at hot yoga – and it made me wonder: Would she have wanted lifesaving medical treatment? Or was that how she would have chosen to go? And what does that class waiver that I signed actually say?
Thinking about potential medical crises or end-of-life scenarios is not easy. However, it is a critical part of estate planning that is often overlooked. Many people focus on dividing assets or deciding who gets what, while spending little time documenting their healthcare wishes.
In difficult moments, a clear care plan brings comfort.
Yet with the fast pace of biomedical innovation, your Advanced Health Care Directive, Living Will, and/or Health Care Power of Attorney may end up being referenced more often – and more urgently – than your Living Trust or Last Will and Testament.
What is Advanced Care Planning (ACP)?
Advanced Care Planning (ACP) is a formal process to document your healthcare wishes in case you are unable to communicate them yourself. This could happen if you are unconscious, in shock and unable to speak, or otherwise unable to respond to emergency medical professionals’ questions. A written health care directive ensures that your preferences about medical treatment -- including what type of care you do or do not want – are known, even if you cannot express them in the moment.
Key ACP Terms
- Living Will - Specifies desired treatments and when to discontinue life-sustaining treatment
- Health Care Power of Attorney – Names an agent to make decisions when you cannot
- Advanced Health Care Directive - Outlines overall medical preferences
ACP is not just a medical formality – it is a key part of estate planning. Without it, your loved ones may face stressful, costly, and potentially emotionally charged decisions during already difficult days. Even the most carefully crafted advanced Health Care Directive or Living Will can fall short if your wishes have not been clearly communicated to the people who may need to speak for you.
The best place to start? A good talk over coffee, not in the ER.
To truly increase the chances that your medical preferences are honored, consider taking the time to talk with your friends and family, your doctor, and perhaps even your spiritual advisor. These open and honest conversations can help convey your values and guide you in thoughtfully completing your advanced health care directive and living will as part of your estate planning.
Pro Tips
- Give a copy of your health care directive to the person you named
- Share the directive with your medical providers and your attorney
- Keep the original in a safe place
Spending a few minutes uploading your health care directive to your medical portal or dropping off a hard copy are simple, proactive steps that can prevent weeks or even months of confusion. Sometimes your health care providers have their own form that they offer that you can complete to supplement and even reference your advanced health care directive.
If your medical treatment preferences are deeply important to you, consider asking your primary care physician to review your medical directive and formally acknowledge your wishes. This extra step may be the one that ensures you will have a health care advocate for your care when it matters most.
You Have Options!
Here are a few important questions to consider as you plan your health care wishes. You do not have to decide everything at once – even starting by considering a couple is a big step if you have not completed your advanced care planning before:
Treatment Preferences
- Would you want experimental treatments?
- How long would you want life-saving treatment to continue – days, weeks, months?
Comfort and End of Life Choices
- Would you prefer to prioritize comfort and pain relief, even if it may shorten your life?
- Would you want time for loved ones to visit before treatment is withdrawn?
Organ and Body Donation
- Are you open to organ donation to save another’s life?
- Would you donate your body to science for research and teaching?
Medical Decision-Making
Would you consent to a medically induced coma to allow your body to heal?
- May your health care agent communicate virtually with your health care providers?
- Should your agent seek a second opinion?
- Would you allow your health care power of attorney to make decisions about psychiatric treatment if they believe you cannot?
Bonus Benefit of ACP: Lower Costs
Beyond honoring your medical wishes and easing emotional burdens, health care directives can also reduce medical costs – without sacrificing compassionate care. By avoiding the all-too-common, heartbreaking question: “Did mom ever say what she wanted?” often results in lower health care bills, and fewer unnecessary interventions.
Did you know? Co-pays and deductibles may still be owed after a loved one passes away.
Advanced health care directives and living wills are also especially important in situations where a person receives an unexpected terminal diagnosis or begins to experience a degenerative condition like Alzheimer’s, dementia, or ALS. In these cases, having medical preferences memorialized formally in a legal estate planning document can provide much-needed guidance and gives more control over how treatment unfolds, as conditions change or the ability to communicate effectively declines.
Medical Planning for Children and Young Adults Who Travel
If you have a young adult over 18 who is traveling, studying abroad, or even just away at college, consider having them complete a health care power of attorney. Once they turn 18, parents no longer have the legal authority to make medical decisions on their behalf --- even in an emergency.
Don’t just pack the passport – make sure everyone knows the medical contingency plan and how to reach you in an emergency, even if you are halfway around the world.
The same applies to minor children traveling out of state or internationally with extended family or family friends. In these situations, it is a good idea to provide a temporary medical authorization and clearly outline your wishes for your child’s treatment.
The Bottom Line …
As life, values, and medical needs change, keeping your estate planning documents up to date ensures your wishes are clear, and more importantly, respected when it matters most. That is why it is important to revisit your health care directives regularly – whether at your annual physical or when updating your Will, Trust, or Power of Attorney.
If you are in need of assistance, the attorneys at Collins Family & Estate Law Group can help.