Should you
get a living will? The readers weigh in.
Our recent
column debating the merits of living wills generated a number of
letters and questions, many of them asking for more information about
how to craft a living will and how to ensure that the document is
available when needed.
Again, a living will is
a written statement about the types of medical care you want (or don't
want) if you become incapacitated. A reader in New York asked simply if
there is a good "rule of thumb" for writing such a document.
One of the best templates is called Five Wishes, which was created by
Aging With Dignity (online at www.agingwithdignity.org),
a nonprofit group based in Tallahassee, Fla., that provides information
and tools to draft health directives.
Five Wishes is a living
will, a 12-page document that prompts individuals to consider five
questions and issues: who your health-care agent should be (the person
to make decisions if you're unable to do so); what kind of medical
treatment you want in various situations; how comfortable you wish to be
(addressing issues like pain medication); how you want people to treat
you (would you prefer to die at home?) and what you want your loved ones
to know (where you wish to be buried, for instance).
Since the document's
introduction nationwide in 1998, about four million copies have been
distributed, says Paul Malley, president of Aging With Dignity. About
600 companies currently offer Five Wishes as a benefit to employees.
Perhaps most important,
the document encourages users to discuss issues that go beyond medical
care, Mr. Malley says, such as spiritual needs and family duties during
a serious illness. "So often, a living will just asks about
life-support treatment," he says. "An 'X' in a box is just not
enough."
Five Wishes costs $5
(bulk orders cost less) and can be ordered at Aging With Dignity's Web
site or by calling 888-594-7437.
In our original column, we noted that one of the biggest problems with
living wills is that people fill them out and forget about them. They
end up in the bottom of a drawer and can't be found when needed. A
reader in Texas called our attention to a simple remedy.
U.S. Living Will Registry (www.uslivingwillregistry.com),
based in Westfield, N.J., will store an electronic version of your
health-care directive and provide copies as needed, 24 hours a day, to
health-care providers anywhere in the country. There's no charge for the
service. (The operation is funded by health-care providers.) Started in
1996, the operation has about 15,000 participants.
More recently, a group
called MyHealthDirective.com
has joined forces with Aging With Dignity to provide electronic storage
of individuals' versions of Five Wishes. The service currently costs $2
a year (the $5 price tag on Five Wishes itself includes the first year
of storage).
David O'Neal, president
of Health care Directive Partners in Waipahu, Hawaii, which operates
MyHealthDirective.com, says he is working with Blue Cross/Blue Shield
plans across the country to market the storage service to companies and
their employees.
Finally, J. Marshall, a
reader in California, cautioned that a living will is far from
foolproof. When her mother was dying in a hospital, Ms. Marshall was
asked by a doctor if she wished to consider life-support measures. When
she responded that her mother's living will ruled out such steps, the
doctor said: "Yes, I know -- but you can override it."
"I was
furious," Ms. Marshall recalled. "My mother's living will
wasn't worth the paper it was written on. I think your readers would be
interested to know that."
Mr.
Malley at Aging With Dignity notes that the ability to supersede a
medical directive varies from state to state. That's why it's critical,
he says, to name a health-care agent who is familiar with your wishes.
"Don't just fill out a document," he says, "with
'treatment' or 'no treatment.'"
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