“POLST vs Living Will” courtesy of Daily Caring: Practical tips for families caring for older adults
A living will is a statement you write up in advance for the type of medical care you want in assorted situations if you should be incapable of telling your health care providers yourself. It also permits you to designate the person you want to make your health care choices for you so be sure to choose someone who will follow your wishes and not their own (one of my sisters thinks a hangnail is too much to suffer; my mother doesn't want her making medical choices for her).
Other terms used to refer to a "living will" include:
- Advance care directive
- Advance health directive
- Advance health care directive
- Five Wishes
- Will to live
- Healthcare declaration
Living Will vs DNR / POLST
Both a living will and a Do Not Resuscitate (DNR) / Physicians Order for Life Sustaining Treatment (POLST) explain the kind of care and treatment you want to receive at the end of your life with key differences.
| Living Will | DNR / POLST |
|---|---|
| Not a medical order | Medical order signed by your doctor |
| Informs medical professionals about the type of general care you’d like, and they can ignore it as they are legally obligated to do everything they can to keep you alive | Informs medical professionals about the type of care you’d like in an emergency medical situation, and they are legally obligated to do what it says |
| Can be filled out at any time in your life | Can only address CURRENT, SPECIFIC medical situations, i.e., you’ve reached an advanced illness |
| It’s part of your medical record and has to be respected by any health care professionals in any location, EXCEPT you must still have the original form available so you can reinforce its directive. |
So What’s the Point of a Living Will?
It’s for your caregivers, your family. It tells them how you want to be cared for. Do your designated healthcare power-of-attorney a favor and make out an advance care directive or living will so they don't have to go through the horrid indecision and worry of having to choose for you. This is a horrible and very emotional decision to have to make for someone else. It tears you apart because you bring your own fears and desires into the decision at a time when you want to be sure that you are choosing the path the patient would want, no matter what you might want. Yeah, just remember that hangnail…
To be effective, your living will must be:
- Witnessed by two people who know you but do not benefit from your death nor provide you with health care
- Readily available for paramedics, doctors, hospitals, clinics, ANYONE who may have a need to treat you in a life-threatening situation
Suggestions on Keeping the Living Will Available
Some of the suggestions I received about availability while helping my friend included carrying it around with me, using a magnet to keep a copy accessible on the refrigerator, and leaving a copy with family, the designated power-of-attorney, each regularly-seen doctor, and at the hospital to which you are likely to be taken.
A More “Permanent” Solution
An even better suggestion is the U.S. Living Will Registry (Registry). Some health care providers will register your living will for you for free (choose your state to see if there’s a medical provider in your area); at worst, you can register a living will for a fee of $59 for five years (it’s renewable after the initial five years by paying $25 for another five years) — consider giving this registration as a gift for the person who has everything!
Once your living will is registered, the Registry will maintain an electronic registration in the nationwide registry and send you a wallet card and your personal registration number as well as send you labels with your registry ID number which you can stick onto your driver’s license or health insurance card. Any health care provider can access the contents of your living will by typing in this ID number.
Once a year, the Registry sends out a letter asking if the choices you made in your living will are still valid — so be sure to add the Registry ID number and their address to your Essential Document Locator Form (PDF or DOC).
There’s an App For That
The American Bar Association has an app, My Health Care Wishes. The Lite version is free and usable for one person while the Pro is $3.99 and covers any number of people and their individual wishes on your smartphone, not in the cloud. It can hold medical, insurance, and contact information with key family and medical contacts, insurance information, and any other health related information you want with instant email, fax, bluetooth, or text connections.
For $3.99 it’s a pretty good deal if only to have that instant access to PDF versions of the living will, advance medical directive (AMD), health care power of attorney (HCPOA, health care proxy), DNR order, psychiatric advance directive (PAD), and POLST (Physician Orders for Life-Sustaining Treatment). I know I’d have a hard time finding the hardcopy version if I’m seizing on a gurney! And the idea of keeping the original hanging on the fridge? How long do you think it’d be before it was “enhanced” with ketchup, jam, and Cheeto stains?
Each State is a Bit Different
While there is a movement afoot (and about time!) for one living will to be legal throughout the United States, each state has particular requirements for a living will to be legal and therefore binding on your health care providers. Everplans has a list of states that allow you to download an Advance Directive for each state. If you’re interested in a POLST, Everplans has State-By-State POLST Forms.
Kathy Davie is an author, editor, and artist with degrees in Technical Writing & Editing, Digital Media, and History from Metropolitan State College in Denver, Colorado.
Kathy fell into the nonfictional end of My Publications when she began researching how résumés and biographies differed for artists. Not seeing any point in keeping the research to herself, she began to write a monthly column on the business end of being an artist, and it’s evolved from there.