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Life Planning & Advance Directives

Talking about Your End-of-Life Care and Understanding Advance Directives

Think of all the preparation involved in the birth of a loved one. The child’s family learns how to care for the new arrival, discusses anticipated problems and prepares both mentally and physically for the life-altering event.

The end of life, like birth, is a major event for the person affected as well as his or her family. Yet, so often the topic of death is approached in such a way as to almost deny that it will occur. This kind of avoidance can pave the way for stress, confusion and discord when a family must finally face the issue. That’s why starting a discussion now about your end-of-life plans is so important.

Give copies of advance directives to your doctor, family members and close friends, as appropriate. You can change or cancel the forms at any time, but they are virtually useless if no one knows about them when the need arises.

Discuss Your End-of-Life Plans

An ethical will helps you discover or reaffirm the values that are important to you. Next, consider how to incorporate those values in your end-of-life care. For example, is it more important to you to die without prolonged pain and suffering, or to extend your life as much as possible to spend time with family and friends? Do you want to be surrounded by loved ones at your death, or would you prefer they keep their distance, remembering you in happier, healthier times? These are tough questions that deserve careful consideration.

Advance Directives

To enforce your treatment preferences toward specific healthcare situations, complete a legal document called an advance directive. Advance directives allow you to give directions for your future medical care. You decide at what stage all medical intervention should stop when a disease is deemed cureless.

Living Wills and Durable Power of Attorney

There are two types of advance directives: living will and durable power of attorney for healthcare. Both kinds of advance directives can help free your family of the responsibility and stress of making difficult decisions for you.

Discuss your end-of-life values with your family while you are of whole mind and body, rather than after a debilitation diminishes your ability to make critical life decisions. For example, an advanced directive can specify whether or not you want to be put on a respirator if you are be unable to breathe on your own.

People often assume that their family will be able to make decisions for them even if they have not prepared an advance directive. However, forcing family members to make such choices for you places a tremendous burden on them. Naming someone as your durable power of attorney for healthcare helps ensure the "right person for the job". If you do not designate a durable power of attorney for healthcare, your next of kin will automatically take on that decision-making role, in accordance with the law in most states.

Living wills, also known as "medical directives" or "healthcare declarations", are written instructions that explain your wishes for healthcare in the event you can’t communicate as a result of a terminal condition or irreversible coma.

Durable power of attorney for healthcare, also known as "healthcare proxy" or "appointment of a healthcare agent", lets you name a person to make medical decisions for you if you become unable to do so. Make sure the person you choose clearly understands your values and beliefs and is willing and able to speak out on your behalf.

Write an Ethical Will

Writing an ethical is a good first step to start an open and honest conversation regarding your end-of-life care wishes. An ethical will, often in the form or a letter, defines your values and beliefs and helps you create a strong legacy for loved ones.

Generally in the format of a letter, an ethical will shares your heartfelt wishes and thoughts with your loved ones and is often read to your family before your death. Common themes seen in modern ethical wills include:

• important personal and spiritual values and beliefs

• hopes and blessings for future generations

• life lessons

• love

• forgiveness

An ethical will is not considered a legal document; rather, it is a meaningful and touching way to leave behind something tangible for your loved ones.

For help in writing your own ethical will, go online to The web site offers helpful tips as well as samples to view. The process of writing an ethical will can be very beneficial in identifying the values and beliefs most important to you, and may also assist you in determining how you want to approach your end-of-life care.

Gain Knowledge

Making decisions about the end of your life should be a life-affirming experience. You are taking control of how you believe major decisions should be handled and ensuring peace of mind for yourself as well as your family.

Download a free advance directive packet, which includes the 27-page "Gift of Peace of Mind" planning document created by Drake University, UnityPoint Health and the Iowa Department of Public Health. We've also included the Iowa State Bar Association's official Living Will and Durable Power of Attorney for Health Care Decisions form. Please provide your name and email address to download this free document. Thank you!