Clarifying your wishes on prolonging life through medical care may be as important as the steps you take to stay healthy. And at some point, you or someone you love might need help with one or more basic activities of daily life.

The time to start planning for these contingencies is now. If you’re a healthy person in your 50s or early 60s, that may sound like odd advice. But it’s good to know a bit about available options before you need to seek them out for yourself or someone else. Hurried decisions made on the heels of an emergency such as a broken hip, stroke or heart attack may not suit you as well as those carefully considered in advance.

Get It In Writing
You can help ensure your health care wishes are known and respected through advance care directives. These directives
address how aggressively you want doctors to pursue life-sustaining measures on your behalf or whether your quality of life
or comfort should be of paramount concern. Two common advance directives are:

• A living will, which states your wishes for medical care if you become mentally or physically unable to make these decisions yourself

• A durable power of attorney for health care or health care proxy, which lets you name a person who will advocate for your wishes

State laws on advance directives vary. In some states, one type of directive has advantages over another, or it may be
possible to combine elements of each. Check with a lawyer or your state attorney general’s office to be sure you comply
with the law, and remember that guidelines may differ if you spend substantial time in different states. A local hospital,
hospice or seniors’ organization may have staffers who can help you prepare an advance directive.

When preparing your advance directive, keep in mind that your wishes can’t be followed if no one knows what they are. Taking the following steps will help:

• Make sure your healthcare proxy knows what your wishes are, because he or she will be making decisions for you if you are unable to do so yourself.

• Talk with your doctor to make sure that your wishes are understood and can be followed. Discuss them with your family, too.

• Your lawyer and a family member should know where a copy of any advance directive is located. Keep a second copy in a safe place and ask your doctor to put one in your permanent medical record. Also, keep a copy in an easily accessible spot in case an emergency occurs and ambulance personnel need to access it.

• Anyone named in a durable power of attorney for health care should have a copy of that document and know your goals for medical care.

• Keep a card in your wallet stating that you have an advance directive, noting where it is, and naming your healthcare proxy, if any.

• Revisit your advance directive periodically with your doctor as changes occur in your life and health. It may help to know that if you have a change of heart at any point while under medical care, your spoken wishes override any written wishes.

The major flaw of advance directives is the impossibility of knowing the exact circumstances under which they will be
invoked, what range of medical options will be available, and how your own feelings might change in the face of reality.
Before you throw up your hands in dismay, consider this: Mulling over your wishes for end-of-life health care can help you
sort out your overall values. That’s the first step in communicating them to loved ones.

Perhaps more than one discussion is needed. Just as important, though, is cultivating a relationship with your doctor and
being willing to talk about death and dying when the prospect of death is no longer academic.

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