Living Will

Also known as: Advance Healthcare Directive, Personal Directive

Last Updated: October 7, 2020

Written by the Open Caregiving Team. Editorial review by Joyce O. Murphy RN, MSN.

What is a living will?

A living will is a written legal document that details your loved one's choices for medical care when they become unable to tell others what they want.

How does a living will work?

A living will is a type of advance directive that lets others know what your loved one does and doesn’t want for care if:

  • They’re in an accident or injured and need emergency care.
  • They become limited in their ability to care for self because of serious illness, dementia, coma, or mental health issues.
  • Their heart or breathing stops.
  • They need to have a tube inserted to help them breathe, a procedure called intubation.
  • They are near death and in the final stage of life.

Your loved one’s living will guides healthcare providers, including first responders, to honor your loved one’s health preferences It will also guide you as a caregiver when making decisions for your them, such as:

  • When they are in a coma because of illness or injury.
  • When they have a life-threatening illness and are unable to speak for themself.
    • This can include choices about potential cures or hopeful treatments.
    • Other examples include when you as a caregiver need to make choices for their pain management, surgery, or hospice care.

The more information your loved one includes in their living will, the more you are able to honor their requests.

Does a living will include do not resuscitate (DNR) orders?

A living will should include your loved one’s DNR and DNI preferences. In addition:

  • DNR orders can be written in a document that is separate from a living will.
  • These may also include DNI orders that state your loved one’s wish to not be intubated when having severe breathing issues.
  • Your loved one will discuss these with their doctor who will approve them.
    • These then become part of their medical or health record.
    • These can also be included in a personal health record.

Who should have a living will?

Living wills are something many people should have, especially those who:

  • Are living with a serious or chronic health condition.
  • Have dependents who will be affected if they become seriously injured or ill.
  • Have a preference on certain types of medical care or treatments.
  • Want to be sure their family caregivers don’t have to make decisions that are hard and or heart-wrenching.
  • Wish to make organ, tissue, or body donations for the benefit of others’ health or learning.

Anytime someone is admitted to the hospital, it is important for them to have their medical choices reviewed.

  • This includes what they want regarding resuscitation and intubation.
  • It may also include:
    • Choices for pain management.
    • What they choose if they need antibiotics, tube feedings, an organ transplant or transfusion, and other treatment options

Why is a living will is important?

A living is important because it will carefully document in writing your loved one’s medical and healthcare choices. These can include care in case of an emergency, diagnosis of a serious illness, as well as end-of-life care.

A living will is about what your loved one wants for themselves. It can include just a few details or many; that’s up to them. They can change their living will whenever they choose based on if its contents still apply and meet their current wishes

Encourage your loved one to review their living will yearly. It can be an especially good time to review a living will when there are significant changes in their health.

Where to find a living will form?

Your loved one can prepare a living will on their own or with input from others. Each state sets its own requirements related to living wills, with some accepting those from other states.

To get your state’s living will written form, visit the U.S. Will Registry website. These can be printed and then filled in. Some can be completed online and then printed. Either way, your loved one will have the document in writing.

Can my loved one make a living will for free?

  • Yes, living wills can be prepared free of charge.
  • Fees for service are charged by attorneys and notary publics.

Where is a living will stored?

  • Your loved one can make copies for their doctor and family members.
  • They will want to keep copies on hand in the event of an emergency. Some people keep theirs in a handy spot like the refrigerator.
  • Some people also store secure electronic copies of living wills.

How to make a living will?

A living will should include clearly written details about your loved one’s medical and healthcare wishes.There are a number of details for your loved one to think about and talk over with their doctor, including:

  • Their decision about being resuscitated if their heart stops. This is commonly known as CPR. If they do not want that, their doctor will sign a DNR order that states they do not wish to be resuscitated if their heart stops.
  • Being intubated because they need help with breathing. This is done using a ventilator while a patient is sedated. If your loved one doesn’t want this, their doctor will sign a DNI, meaning do not intubate.
  • Tube feedings that give their body nourishment. This is done via intravenous, stomach, or nasal tubes. They may choose this to continue life, or prefer not to do so.
  • Kidney dialysis works in place of kidneys that are no longer able to clear wastes from bodily fluids.
  • Medicine to fight a virus or bacterial infection. Some people would rather have the infection run its course and others choose to use it, possibly prolonging life.
  • Comfort or palliative care that provides for control of your loved one’s pain. It includes other options, such as being able to die at home.
  • Organ or tissue donation that may include the need to specify life functions being managed while the gifts to others are prepared.
  • Having their body donated for scientific research.
  • Any religious or spiritual considerations.

Support your loved one in taking steps to talk with family members and close friends about their wishes. This is especially important for you and any other potential caregivers. Talking through these topics with caregivers and family helps people to relate to your loved one’s choices and add to the conversation.

What is the difference between a living will and a will?

There is a big difference between a living will and a will, although the terms seem to be quite similar.

  • A living will focuses on medical care decisions while your loved one is alive.
  • A will (or last will and testament) goes into effect when your loved one passes.
    • It includes how assets such as property and money are to be distributed to heirs and/or others.
    • It designates guardians for your loved one’s dependents, such as minor children..

What is the difference between a will and a living trust?

Both a will and a living trust involve property.

  • A will is used by your loved one to state who will get which items and/or pieces of property.
  • A living trust also names beneficiaries of property, but that is put into a trust.
    • This is an option when your loved one has minor children as they cannot own property.
    • Trustees are selected to manage the trust after your loved one passes.

Is a living will an advance directive?

There is overlap between the functions of advance directives and living wills. To add to potential confusion, each can vary from one state to the next.

  • Advance directives are broad and can include who your loved one name’s to make healthcare decisions when they cannot.
  • A living will is a special type of advance directive. It gives specifics about your loved one’s choices for medical decisions, such as:
    • Whether or not to resuscitate.
    • End-of-life choices for pain management or antibiotic therapy.

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