As our population ages, the problem of convincing people to make affirmative decisions about how they want to be treated at the end of their lives grows in scope and seriousness. Just as lawyers are able to help people make end-of-life decisions about their possessions through wills and trusts, they also can serve as a resource for planning for end-of-life care, and communicating these decisions to family and loved ones.

The recommended approach is a process known as advance planning. This process involves thinking about what aspects of living are most important as the end-of-life approaches, talking to loved ones and completing an advance directive, which can take several forms.

One is a living will, which outlines specific actions that caregivers should take during treatment if the person is incapacitated and unable to give instructions. Another more versatile form is a health care power of attorney or a health care proxy that names an individual to make decisions on behalf of the person. Having a legally authorized spokesperson who knows the person's wishes and values, and who can respond to medical circumstances at the time they are known is the most effective strategy to have in place. A third type of advance directive is a combination of the two, such as the Five Wishes document, that addresses a person's medical, personal, emotional and spiritual needs. Some states have their own forms for advance directives.

To clarify end-of-life priorities, the American Bar Association's Commission on Law and Aging has developed a consumer toolkit to help lawyers and their clients work through important planning issues and options. The kit contains ten tools that address such options as how to select a health care proxy and what to do after signing the advance directive as well as a guide for health care proxies and additional resources.

After reflection and discussion, individuals can complete an advance directive form, including naming a health care agent or proxy if there is someone they trust to serve in that role. The directive should include wishes about special treatments, such as artificial hydration or nutrition, as well as guidance about values, beliefs, quality of life or other care preferences. This guidance ensures that the individual's wishes are known and respected. It will also spare loved ones the anguish of having to make hard choices without input and will help avoid disagreements among family members.

People are hesitant to complete advance directives because they think they will have time to do so when they are older or more ill. Or, they may feel that they are creating a reality when they express their end-of-life wishes in words. In fact, the reality is that conversations about end-of-life planning are life-affirming and should happen before the need appears on the horizon.

For a copy of the toolkit, please contact the __________ Bar Association at XXX-XXX-XXXX or download a copy at http://www.abanet.org/aging/toolkit/home.html.

© 2007 American Bar Association