Elder Law: Living Wills and the Designation of Health Care Surrogates

It’s important for you to express in a document what you do and do not want in regards to your medical care if you’re unable to communicate them yourself.

Even though you may feel uneasy about discussing living wills and the designation of health care surrogates, it’s a conversation you need to have with your loved ones.

Read on to learn what you need to know about living wills and the designation of health care surrogates. While you may not want to face your own mortality, it’s important to be prepared in the event of a medical situation.

What You Need to Know About Living Wills and the Designation of Health Care Surrogates

Living Wills

You don’t have to have a medical degree to complete living wills, but it helps to familiarize yourself with the types of medical procedures administered to patients who are critically ill. And in most states, living wills outline whether or not you want to receive life-extending procedures at the end of your life, such as:

Administration of drugs.
Cardiopulmonary resuscitation (CPR).
Diagnostic tests.
Dialysis.
Palliative care (pain relief).
Transfusions of blood and blood products.
Tube feeding.
Surgery.
Use of a respirator.

To learn more about these, speak with your doctor, a patient representative at a hospital, or a health insurance plan office.

In addition to life-prolonging procedures, you may consider expressing your intentions with regards to donating your organs and/or body for scientific research.

Ironically, you don’t have to include DNR (do not resuscitate) and DNI (do not intubate) in your living will. You can simply tell your doctor your preferences and he or she will write the orders and place them in your medical file. But to ensure your wishes are carried out, you may want to include these in your living will.

Many states are including or replacing DNR with POLST (Physicians Orders for Life-Sustaining Treatment) or something similar. Forms would include directions to your health care provide about other life-extending treatments. It’s kind of like an advance health care directive or living will, but not a substitute.

If you haven’t created a living will, consider doing so. In addition to writing down your medical care wishes, you may consider including your values, personal goals, and health outcome. These include but are not limited to funeral and memorial plans, grooming instructions, and more.

Delegation of Health Care Surrogates

According the Patient Self-Determination Act of 1990, “a patient has the right to formally designate a surrogate to make treatment decisions for the patient if the patient becomes unable to make their own decisions. A surrogate decision-maker, or durable power of attorney for health care (DPA/HC), must be documented.”

Health care surrogates are individuals you designate to make medical decisions on your behalf if you’re unable to do so yourself.  An attorney can create a health care surrogate designation document. You can include instructions about any treatment you do or do not want, similar to a living will.

You may also choose to name an alternate surrogate. Why would you want to do this? Because the person you originally chose may be unwilling or unable to perform his or her duties. Or if they should pass away, you’ll need another surrogate who can give consent for medical treatment and surgical and diagnostic procedures.

As long as you’re of sound mind and body, your health care surrogates can’t override what you want. They only intervene if you’re unable to make decisions on your own. Furthermore, you can restrict the authority of your health care surrogates. For example, you may specify that they can only carry out the details of your living will.

Carefully consider your health care surrogates. Not only do you want to select people who’ll have your best interests at heart, but you want them to be able to act thoughtfully should your medical circumstances change.

Living Wills and the Designation of Health Care Surrogates

Creating living wills and designating health care surrogates gives you the opportunity to ensure that your medical care and wishes are carried out. It also relieves caregivers from making decisions in a moment of grief or crisis. Furthermore, a living will and designation of a health care surrogates reduces confusion or disagreement about the choices you’d want loved ones to make on your behalf.

Want information on the documents you need to have before you die? Download a reference sheet.