End-of-Life Paperwork Everyone Should Do Now

Selecting the right person to give this responsibility to is critical. That person should be someone you can trust with crucial decision-making and who will advocate based on your expressed wishes. The Conversation Project online offers a guide for choosing a healthcare proxy.5

POLST/MOLST

Other documents you may see referenced under the advance directive umbrella are portable medical orders, which go by several names, including POLST (physician [or provider] orders for life-sustaining treatment) and MOLST (medical orders for life-sustaining treatment).6

These medical orders tell what medical care or intervention you do or do not desire. While the topics covered are similar to those in a living will, the POLST/MOLST is a medical form, completed with your physician, rather than a legal document, completed with your attorney.

DNR

A do not resuscitate order, or DNR, tells medical staff that you do not want CPR or other lifesaving measures if your heartbeat and breathing have stopped. In a medical emergency, in the absence of a DNR, medical staff will attempt to restart your breathing and heartbeat.

HIPAA Access

Another important form that's simple to complete, yet could be easy to miss, is a HIPAA (Health Insurance Portability and Accountability Act) Right of Access Form, which gives your designated family and friends the right to receive protected medical information from your healthcare providers.7 This form comes in handy even in non-emergency situations.

Getting the Conversation Going

Establishing your advance directives is an act of deep care and concern for those you love. It's essentially a three-step process: making the decisions; putting them in writing; and then communicating them.

An important part of making these decisions is talking with your family, close friends, medical providers and legal professionals. You may find it takes several conversations to address all the questions and issues you have. You'll want to take special care in selecting your healthcare proxy (the person you'll grant your medical POA to), since they will be acting on your behalf when you're unable to make medical decisions for yourself.

Learn More

Sometimes the best place to start is by educating yourself. If you want to know more before talking to loved ones and professionals, here's a short list of places to start:

CaringInfo, a program of the National Hospice and Palliative Care Organization, offers meaningful resources for educating yourself on advance directives and other end-of-life topics, such as palliative care, hospice care and communicating with family and friends.8

The American Bar Association's Health Care Advance Planning Packet offers free resources on appointing a healthcare proxy.9

Each state has its own advance directive forms, which may provide detailed questions and prompts.10 These forms can help guide your planning with family and friends. They also include guidance for putting a medical POA (healthcare proxy) in place.

I've Completed the Forms. Now What Do I Do?

It's not enough to just complete the right forms. You also need to proactively provide them to your healthcare providers — and to loved ones who may need them some day to officially act on your behalf.

Also consider that your first point of contact may be an emergency medical team that arrives at your door. They won't know if you've signed a DNR or who to contact in an emergency. Consider posting a copy of your DNR, as well as a list of emergency contacts (like your doctor and your healthcare proxy), in plain sight — ideally near the door they are likely to enter.

Take Action Now

The best time to put advance directives in place is well before you need them. Don't let the variety of options keep you from taking action. The most challenging part of putting these documents in place is starting the conversations and making the decisions. After that, the rest is just completing paperwork — and conveying the information to the right people.