What Is a Living Will?

A living will is a legal document that outlines your preferences for medical care if you become incapacitated. Though part of your estate plan, it is different from a last will and testament, which details how you want to distribute your assets. 

People often think writing a living will can wait until sickness, terminal illness, or old age. But unexpected injury or disease can strike at any time, not just to older adults in the last stages of an illness. Read on to learn more about what living wills are, how to create one, and what to consider including in yours.

The purpose of a living will

A living will is used to instruct care providers in the event that you can no longer make decisions for yourself. It can also shield your loved ones from having to make difficult choices about your care and reduces the chances of confusion or arguments over what's in your best interest.

How to write a living will

Each state has a living will form or specifics about what one should include. The form is free. Be sure to note your state's requirements to ensure your form is enforceable. If you spend lots of time in other states, you may want to make sure your living will is enforceable in those states too. The following steps are a general guide to writing living wills, an essential component of an estate plan.

1. Speak with your doctor

If you have a primary care physician or a doctor you regularly see, have a conversation with them about your future care. Doctors can walk you through procedures and treatment options, helping you make an informed choice about the care you wish to receive.

2. Choose what kind of care you want

Your medical care is a personal decision, whether it's a serious illness or end-of-life care. Certain treatments can be tough on the body, and you should consider how long you would be willing to go through specific regimens. If comfort is a priority for you, make sure that's made known in your living will.

3. Talk with family members and close friends

A living will can remove the burden of making difficult decisions from your friends and family. Communicate with them so they're aware of your healthcare and end-of-life wishes.

4. Name who should make decisions for you

A living will contains your healthcare wishes for care as well as naming the person who is able to make decisions on your behalf. In the event of an unforeseen complication, such as a serious illness, you'll need a representative with your best interests in mind who will have medical power of attorney.

A healthcare proxy (or healthcare power of attorney) is a person legally appointed to make healthcare decisions on your behalf. This is different from a financial power of attorney, which designates a person to make financial decisions on your behalf. A healthcare power of attorney can be included as part of your living will, or it can be its own separate document, depending on your state.

One important consideration is the potential for disagreements between your healthcare proxy and your representative with power of attorney. Choosing the same person to fill the roles of a healthcare agent and a representative with financial power of attorney reduces the potential for conflict.

State laws vary regarding appointing a healthcare agent. A common restriction is the healthcare agent can't be your attending physician. Check state laws to determine who can be your healthcare agent.

5. Get legal assistance

Writing a living will, as well as an estate plan, takes lots of foresight and consideration. Living wills are legal documents. Speaking with a lawyer can help ensure the living will form, and the document is written in a clear and instructional way that leaves little or nothing open to interpretation regarding your health care.

You'll need to sign the living will in accordance with state laws. This typically includes signing before a notary or witnesses who affirm you are sound of mind and not under duress. Note that you can revise your living will at any time by completing a new document, but it's important to make sure all previous versions are destroyed.

6. File copies of your will with important parties

While it may be tempting to keep your living will private, it's important to remember that many people may need access to this document for advance care planning. If they can't find it, your healthcare wishes may go unrecognized. Consider keeping an original copy of your living will at home and sharing additional copies with:

• Your doctor
• Your hospital
• Your nursing home
• Your healthcare proxy or representative with durable power of attorney
• Your immediate family

Keep copies of your living will with multiple parties to ensure that relevant parties have access to your care preferences and wishes.

What to include in a living will

Living wills are only for medical treatment and end-of-life care, and any possible health care or treatment outcome should be considered. Use the following scenarios as a starting point, and make sure to talk to a lawyer and doctor to discuss the most common types of healthcare issues, such as end-of-life care, before finalizing your living will.

Breathing assistance

A ventilator helps you breathe when your body is no longer able to do so on its own. This can sustain you for long periods of time, so it's important to consider in your healthcare plans if you wish to be placed on a ventilator at all and if so, how long you would want to use one before being taken off.

Supplemental feeding

Tube feeding provides essential nutrients when you're unable to feed yourself. If you wish to be fed intravenously or with a stomach tube, you should note in your living will when and how long you would like this healthcare treatment to continue.

Medications and treatment

Antibiotics and a life sustaining treatment like dialysis can fight infections and remove bodily waste. Many can be life-saving, but you might not wish to receive a particular life sustaining treatment for an extended period of time. Talk to your doctor about various options and their side effects so you can make an informed decision on your care and treatment.

Palliative care

Palliative care is often called comfort care because it's meant to reduce pain and focus care decisions on improving comfort and quality of life. You might wish to receive pain medication or to avoid aggressive treatments and invasive tests to prioritize your comfort.

Bodily donations

In a living will, you can declare whether you'd like to donate:

• Your organs
• Your bodily tissues
• Your entire body

A living will help timely organ donation for viable transplants. While you can register for organ donation through a state registry or with your local bureau of motor vehicles, a living will is considered the best way to convey your wishes. You can also declare whether you would like your body to be donated for scientific research purposes.

Posthumous decisions

A living will, in addition to answering questions on organ and other bodily donations, may grant consent to:

• An autopsy to determine the cause of death
• A cremation, burial, or another manner of handling your remains

These are decisions that you should make for yourself. Read on to learn how to create a living will that can help keep you covered in almost any situation.​

Who needs a living will?

Living wills should be considered by everyone and can provide you and your loved ones with peace of mind.

Creating a living will when you're healthy allows you to consider all of your options carefully and makes it so your loved ones aren't left with difficult choices without knowing your wishes. If you're undergoing surgery or are critically or terminally ill, a living will is especially important.

If you don't have a current living will and become incapacitated or are unable to make your own decisions, your physicians will turn to your closest family members (typically spouse first, then children, but the order depends on your state) to make medical decisions.

Living wills are particularly important because many states require them to dictate that your representatives have full authority to make medical decisions for you. In some instances, without a living will, a court order is required to end life support, which can be expensive and heart-wrenching. Doctors may also be allowed to decide which family member's viewpoint is the one to follow.

Can a living will be broken?

There are a few instances in which a living will will not be followed:

By authority of a healthcare proxy

Your appointed representative has the authority to make medical decisions for you, including those that may go against the wishes you've stated in your living will. It's important to appoint a representative whom you trust.

If your living will is deemed invalid

Your state might consider a living will invalid for a number of reasons. If you don't have the proper witnesses, have previous wills that haven't been destroyed, your mental state is questionable, or a court finds that fraud influenced your will, the decisions you made in your living will may not be followed.

What is the difference between living wills and advance directives?

Advance directives and living wills are not always identical. An advance directive can include a living will but might also include:

• A medical power of attorney agreement
• Any important information about prior health conditions

An advance directive, also called a healthcare directive, is a comprehensive document that includes a living will in addition to other important, clarifying information. You can have several advance directives but only one living will. Medical practitioners can have faster access to advance directives than to living wills.

While advance directives outline a person's wishes regarding emergency medical treatments such as cardiopulmonary resuscitation (CPR), advance directives have some drawbacks. Patients may change their minds about their medical choices.

Be sure to consult with a lawyer to determine what should be included in advance directives.

What is the main drawback of a living will?

Living wills can have oversights—it's impossible to foresee everything that could happen to you. These legal documents must be broad in what they cover while mentioning as much specific information as possible to mitigate gaps.

What to consider before creating a living will

Before creating your own living will, you should consider how you feel about the possibility of a range of medical treatment options. It might also benefit you to have conversations with those closest to you to decide if any loved ones have the capabilities to be your healthcare proxy. Ask yourself these questions before creating a living will:

• Would I like to receive any and all treatments available in the interest of prolonging my life?
• Would I rather prioritize my comfort and convenience?
• Do I prefer to stay at home over being hospitalized?
• Which family members, friends, and loved ones can I trust to act in my best interests regarding health care?
• How much money do I have to cover medical expenses where insurance falls short?
• Does my state require witnesses, a notary, or both when signing my will?

This is not a complete list of questions but rather a starting point for conversations between you and your doctor or lawyer to create a living will.

It can be difficult to think about a potential end-of-life situation and the type of medical care you'd like to receive during it. Preparing a living will is a significant undertaking, but it's ultimately worth it to reduce the stress and burden of the unknown on yourself and your family

A living will is a legal document that outlines your preferences for medical care if you become unable or incapacitated. It is different from a last will and testament, which details how you want to distribute your assets after death. A last will and testament is not effective until you die.

How old do you need to be to create a living will?

You need to be 18 years old and of sound mind. Parents of minor children or the legal guardian make healthcare decisions for them until minor children turn 18.

Are living wills the same as living trusts?

No, living wills pertain to healthcare decisions in the event of illness or end of life. Living trusts allow you to avoid probate court and distribute assets according to your wishes.