A Living Will is a legal document that is typically part of an Estate Plan. In a Living Will, you express your wishes about the medical care you would like to receive at the end of your life. It includes instructions about when and under what circumstances you want medical care to be withheld or withdrawn resulting in your death. The instructions in your Living Will guide the person named as your health care agent in your Health Care Proxy in making end of life health care decisions for you when you are unable to do so. To put it bluntly, you are instructing the health care agent when it is okay to “pull the plug”.
If you do not have a Living Will, Massachusetts law presumes that you wish your life to be extended as long as possible with all available medical treatments and interventions, even if you have a poor quality of life with little chance of recovery. If that is not your wish, you should put your wishes in writing by signing a Living Will that expresses your wishes. Verbal instructions to family members are not legally binding.
A recent and interesting NPR program focused on a team of doctors at the University of Washington who are advising patients, while still healthy, to sign a dementia-specific Living Will. Their sample dementia directive form includes specific instructions about end of life care for those suffering from Alzheimer’s or other forms of dementia. It allows the patient to express different wishes about desired care at different stages of illness – mild, moderate and severe
These doctors believe specific language for dementia should be included in a Living Will because dementia is unique and as dementia progresses patients become increasingly unable to express wishes about medical care and the side effects of that care become increasingly intolerable. The University of Washington doctors also cite the increasing number of people who will be suffering from dementia in the future as another reason to specifically address this issue.
I advise all my clients to sign a Living Will and offer my clients recommended language. The Living Wills I recommend do not yet include specific instructions for dementia. Although I do not specifically endorse the University of Washington sample dementia directive form, I believe this is an important issue and intend to pay more attention to it in the future. If you wish to explore this issue further, consult an estate planning attorney or check out the resources available at The Conversation Project.