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  • What Are the Differences Between a Living Will and an Advance Directive?

    People take a wide range of proactive steps to plan for their future, from contributing to a pension or a retirement plan to setting aside money to pay for their children’s college tuition. Even though we must all face our own mortality at some point, people often avoid thinking about or even discussing important decisions that need to be made about the end of their lives. To avoid potential legal issues, and ensure that your wishes are carried out, it is highly recommended that you set up a living will or an advanced directive. It is important that you understand some of the key differences between the two before you decide which document makes the most sense for your circumstances. A skilled estate lawyer can address your questions and concerns and recommend the best legal course of action.

    What Is an Advanced Directive?

    An advanced directive is any type of legal document that clearly outlines your exact wishes regarding future medical care if you are incapacitated or are unable to communicate due to a stroke, a coma, an illness, or injury that left you unable to communicate, or advanced dementia. The document can be customized to reflect your religious, spiritual, or philosophical beliefs, and the impact that these beliefs may have on the care you wish to receive. The following are items that are generally included in an advanced directive:

    • A medical Power of Attorney (POA): This allows you to choose someone to be your health care proxy or agent. That person will be able to make important healthcare decisions on your behalf if your are unable to do so. He or she will also have the power to talk to your healthcare provider and ensure that your wishes are enforced.
    • Psychiatric Advance Directives (PAD): This a legal document that allows you to specify your preferences for any future mental health treatment that you may need. It also allows you to name an individual that can make decisions for you in a crisis if you are unable to make those decisions for yourself.

    What Is a Living Will?

    A living will is another example of an advanced directive. It clearly specifies any advanced medical treatments that you would want to have done to keep you alive, as well as treatments or medical procedures you do not want if you are unable to make decisions or express your wishes. It also specifies your preferences regarding pain management and organ donation. In most cases, a living will specify your wishes regarding life-sustaining efforts if you become terminally ill. When considering end-of-life care, it is recommended that you talk to your doctor if you have any questions about the following medical issues so that you can make an informed decision:

    • Cardiopulmonary resuscitation (CPR): This restarts the heart after it has stopped beating. In a living will, you can specify whether you wish to be resuscitated, if you want to be resuscitated by CPR or a defibrillator.
    • Mechanical ventilation: If you are unable to breathe on your own, this device takes over your breathing. It is important that you consider whether you want to be put on a mechanical ventilator, and for how long. By making these decisions ahead of time, and having them in writing in a legal document, family members will not have to determine if and when you should be taken off the ventilator.
    • Feeding tube: If you are unable to eat on your own, you may require a feeding tube to ensure that your body is getting necessary fluids and nutrients. A feeding tube supplies the body with these nutrients via a tube that is placed in the stomach. You can specify whether you wish to be fed in this manner, and for how long if feeding becomes an issue.
    • Dialysis: This is a procedure that removes waste from the blood and manages excess fluid if the kidneys are no longer functioning properly. A machine removes blood from the body, filters it through a dialyzer and returns the cleaned blood to the body. The process can take up to five hours and patients generally need to have the procedure done three times a week. Consider whether you would proceed with dialysis, and how long you would want to continue this treatment.
    • Medications: There are several medications you can take that can prolong your life if you are suffering from a serious infection. Antibiotics and antiviral medications can be prescribed to fight the infection. However, you can specify whether you want to take these medications, and for how long. Alternatively, you may specify that you do not wish to be given any prescription medications if you would prefer to let the infection run its course.
    • Palliative care: Also known as ‘comfort care’ or ‘hospice,’ the main goal of this type of care is to ensure that you are comfortable, and that your pain level is being managed. Oftentimes, this type of care is provided in the patient’s home when they are approaching the end of their life. You may specify whether you want to receive palliative care in your home, or if you wish to remain in the hospital.
    • Organ donation: You can also specify in your living will that you are an organ donor. If you wish to donate your organs, you will need to remain on life support until the retrieval process is complete. It is highly recommended that you specify in your living will that you understand that this temporary intervention is necessary.
    • Donating your body: You can also choose to have your body donated to a local medical school or donation program. To learn how you can do this, contact the medical school or donation program in your area to find out how to register for a planned donation for research purposes.

    What If I Want to Include a Do Not Resuscitate (DNR) Order?

    If you would like to establish a DNR order or a do not intubate (DNI) order, you are not required to have an advance directive of a living will to have your wishes met. You simply need to notify your doctor about your preferences and he or she will include that information in your medical record.

    Why Are Advanced Directives and Living Wills So Important?

    No one expects to suffer a debilitating injury, severe illness, or health complication that restricts their ability to communicate their preferences when it comes to medical care. It is important to prepare for the unexpected, and advanced directives and living wills are important estate planning tools that allow you to do so. By making these decisions when you are thinking clearly and rationally, you can avoid having to burden family members with making very difficult decisions when tensions and emotions are running high.   

    What Is the Main Difference Between the Two?

    An advance directive is any type of legal document that outlines one’s wishes and preferences regarding their future medical care. It covers a broad category of legal documents that includes a medical power of attorney, a psychiatric advance directive and a living will. A living will is a type of advance directive. While this the basic difference between the two, understanding the differences can sometimes be confusing for the following reasons:

    • There are no specific rules for what you should include in an advance directive. Depending on your specific circumstances, you can include a wide range of healthcare decisions or focus on a specific procedure.
    • The laws can vary from state to state in terms of what is considered a valid advance directive. For example, some states require written legal documents while others allow verbal advance directives. In the state of Virginia, advance directives and living wills must be in writing.
    • Advance directives and living wills may be referred to in different terms in different states. For example, living wills are also known as medical directives or advance healthcare directives (AHCD). Advance directives are also called healthcare directives, advance medical directives, advance care directives, health care proxies and designations of health care surrogate. To make matters more confusing, the terms ‘living will’ and ‘advance directive’ are often used interchangeably.

    Virginia Beach Estate Lawyers at Anchor Legal Group, PLLC Assist Clients with Estate Planning

    If you or a loved one requires legal assistance with a living will or an advance directive, do not hesitate to contact the Virginia Beach estate lawyers at the Anchor Legal Group, PLLC. We will assist you with every step of the estate planning process, address your questions and concerns, and ensure that your wishes regarding your end-of-life care are carried out. To schedule a free, confidential consultation, call us today at 757-LAW-0000 or contact us online. Located in Virginia Beach, we serve clients throughout Virginia Beach, Chesapeake, Norfolk, Suffolk, Portsmouth, Newport News, Hampton, Eastern Shore. We also serve our clients throughout the United States through our network of associated attorneys.