If you're either unconscious or otherwise unable to communicate, a living will tells others what treatments you'd like—or want to avoid. Typically, a living will comes into play when you're no longer able to participate in decision-making and hope to prevent the prolonging of an inevitable death through artificial means.
But before creating a living will, it's important to learn the definition of a living will, how it works, what’s included, and why you might want one. As well, you may find that you’re more interested in an alternative to a living will.
Definition and Example of Living Wills
We often think of a "will" as a document detailing how we want our property divided after death. But a living will is only concerned with the type of medical care you do or don't desire if you're unable to speak. For example, if you are seriously injured, in a coma, suffer from severe dementia, or are dying.
Living wills are a type of advance care directive or legal document that shares your wishes with physicians, hospital staff, and your family. You can include your living will as part of your essential estate planning documents. Other types of advance directives that may be part of the living will or added to it include:
- Appointment of a health care representative or proxy: A person you appoint to make health care decisions for you
- Organ donation guidance: Typically filled out online or kept with other important papers
Verbal instructions to family and friends may replace previous requests in writing. You can also revoke your living will at any time, as long as you’re able to make medical decisions.
How Do Living Wills Work?
A living won't kick in just because you’re temporarily unconscious—say, from a short-term concussion. Instead, a living will is concerned with treatment that artificially prolongs dying if you’re in a mental or physical state without hope of recovery.
Living wills are often regulated at the state level, with free, straightforward forms available for individuals to fill out in consultation with health care professionals. Typically, forms include sections on:
- Conditions: Such as a terminal or irreversible disease, permanent mental confusion, physical dependency, or pregnancy
- General treatments: Comfort or life-sustaining treatment
- Specific treatments: cardiopulmonary resuscitation (CPR), hospital admission, tube feeding
Depending on your state, a living will form might tell your family and care providers under which circumstances you don’t want the following treatments:
- Resuscitation if your breathing or heart stops
- Breathing machine support
- IV or tube feedings
- Blood transfusions
- Tests, surgeries, or other procedures
Usually, the living will form needs to be signed by witnesses and potentially filed with a state entity for safekeeping.
Unfortunately, it is still possible that a physician can override your wishes despite a living will. Often, such situations are due to misinterpretation or miscommunication between physicians or family regarding the living will.
To decrease the chances of a misunderstanding, ensure that others know about and understand your living will. Give a copy to family members and your health care provider, and keep a copy with your other essential documents. If you’ve appointed a health care proxy or representative, ensure that they have a copy of your living will as well. You may also want to keep a wallet-sized copy of your living will with you at all times
Even if you don’t want to be kept alive artificially, living wills shouldn’t take away pain relief treatments through medication or other measures.
Do I Need a Living Will?
Both healthy adults and those with chronic conditions might create living wills and other advance care directives. Living wills can provide guidance to physicians and concerned family, without burdening others with making life-or-death decisions on your behalf.
Alternatives to Living Wills
Two alternatives to DIY living wills are types of voluntary medical orders, which must be signed by a physician or another state-approved health care professional. These are typically for individuals in poor health or who have specific requests:
- POLST: This acronym stands for "Physician Orders for Life Sustaining Treatment ", sometimes called portable medical orders, which are a form with more specific instructions on end-of-life care and signed by your physician, along with your signature or the signature of your health care proxy. May be called by similar but different acronyms in some states but it is recognized in most states.
- Do-not-resuscitate (DNR) orders: These medical orders are typically a form-focused only on resuscitation, not other forms of care, when in an emergency.
Living Will vs. Living Trust
A living trust is more like a traditional will. It’s a type of legal document that helps manage your estate both before and after your death. A living trust isn’t concerned with health care wishes.
Living Will vs. POLST
A POLST is a more complex medical document, while a living will is a legal document. Your health care provider fills out the POLST after discussing the treatments you want in an emergency. You can’t use it to appoint a health care surrogate or proxy, but it can be used by emergency responders to avoid providing you with CPR or a trip to the hospital. Some states have specific forms that must be used for a POLST.
How Much Does a Living Will Cost and How Do I Get One?
A living will’s cost can be free to minimal. Some states offer free forms you can fill out with your specific wishes. Other states may allow you to record your living will for a small fee, although you may need to find a notary or witnesses. You can also work with a lawyer to draft a living will, and may be able to use online will-making sites.
- A living will instructs physicians and family on how you’d like to be cared for if you’re no longer able to communicate due to advanced illness or an unconscious state.
- Research your state’s approach to living wills; many states offer free, fillable living will forms.
- A living will allows you to outline treatment preferences for various conditions.
- If you want to provide more comprehensive instructions, consider a POLST, or portable medical orders, signed by your doctor.