Living wills: Everything you need to know about planning ahead medically

Less than one in five Canadians have a living will or advance care plan according to a poll conducted by Advance Care Planning Canada.

This commonly overlooked part of estate planning is something people of all ages should think about — to give their family a break in difficult situations.

So what exactly is a living will and how do you set one up?

Do I need a living will?

A living will, also known as an Advance Directive, is a legal document that provides instructions should you become incapacitated and unable to make decisions for yourself. Specifically, it dictates what you do and don’t want done in specific medical situations.

The main purpose of a living will is to provide instructions for doctors and healthcare providers should you become unresponsive and require life-saving intervention. The living will lays out what procedures you want done and for how long these are to be administered.

Some things you can lay out in your living will are:

• Whether or not you want cardiopulmonary resuscitation (CPR) performed and for how long
• If you want to donate your body to medical science
• If you want to donate your organs or living tissue
• What palliative care you want to receive
• If you want to receive mechanical ventilation if you can’t breathe yourself
• If you want to receive tube feeding
• What medications you are willing to receive and how long these should be administered
• If you want to receive dialysis in the event of kidney failure

When such instances arise, your loved ones may be unreachable, or they may not be aware of your desires. Having a living will not only provides direct instruction for what you want done, but it also can help save frustration and stress for your loved ones should the unimaginable occur.

Living wills also help healthcare workers make life-or-death decisions for you if you are incapacitated. That’s why a living will is a good idea at any age.

If, for instance, it is important for you to have your body donated to medical science, this should be known as it influences the types of interventions that medical staff will perform. Similarly, if you have specific religious or ideological beliefs that dictate what procedures you want performed, a living will can communicate these if you are unable to.

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Living wills vs. advance directives vs. personal directives

You may hear the names living will, advance directives and personal directive used interchangeably. And technically, they are the same thing.

Living will is generally the more common language, while “advance directive” is the legal term. In Alberta and Nova Scotia, “personal directive” is generally used in legal matters. Health care directive is another name you might encounter, depending on what province you live in.

Regardless, when living wills, advance directives or personal directives come up, it all refers to the same thing.

Types of advance directives

While living will and advance directives can be used interchangeably, the legal term “advance directives” embodies all of the elements of your personal care instructions. This includes the following:

• Living will: A living will can be considered the instructions for your health care. It provides details on who you would like to execute decisions on your behalf as well as what those decisions are.

The living will can contain things like what kind of life support you want to receive, how long you want to receive it for, do not resuscitate directives (DNR) and if you want to donate your body for scientific research.

You should also include specifics on how much control over your health interventions you want assigned individuals to have, as well as instructions on who is to care for dependents should you be unable to.

• Power of attorney: The power of attorney is the individual who will make decisions on your behalf. There are two types of power of attorney: those for possessions and those for personal care. You can appoint the same individual to act as both, but it is important to note that only the power of attorney for personal care will be able to make medical decisions on your behalf.

• Health care proxy: A health care proxy is another name given to the power of attorney for personal care. Depending on your province, you may see these terms used interchangeably. Generally, the health care proxy needs to be over 18 years of age (19 in some provinces, 16 in Ontario) and mentally capable of making decisions on your behalf.

Remember, it is important that you assign your power of attorney and health care proxy. Some provinces offer online forms to help with this process. In most instances, you are required to have a written document signed by yourself and witnessed by individuals other than your proxy.

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How to set up a living will

Each province has specific requirements about what is required for an advance directive or living will, so you should take the time to consult your province’s health services for specific information.

In general, you will need to assign a power of attorney for personal care (that is, a healthcare proxy), and create a document outlining your healthcare wishes.

You don’t need to go to a lawyer to create a living will. Many provinces provide online forms you can print and fill out, but remember that it’s important to have the documents witnessed by individuals other than your proxy.

Will vs. living trust

Another term you might encounter is “living trust”. Where wills dictate what happens to your assets after your death, a living trust can be used to distribute your assets and property according to your terms while you are still alive.

For instance, if you have three children, and want them to each receive $10,000 yearly from your assets, you could place a sum of money in a trust that will then allocate it on your terms.

The individual who establishes the trust, or the settlor, can maintain control over the trust for as long as they desire up until their death.

Creating a living will may not be essential, but it can save loved ones stress and frustration should the unimaginable occur. When you are estate planning, it is worth taking the time to create a living will in order to let others know precisely what types of interventions you may or may not want.

Read more

• Why writing a will is crucial to avoid family dispute