Is a living will the only one I need?

By Amy Lewis, PLLC

When it comes to planning for their future health care, most people’s first thought is that they need to have a living will (called a “Health Care Directive” in Washington).  Once they have a Health Care Directive in place, then most people feel that they have future health care decisions covered.

Unfortunately, a Health Care Directive is only one of the documents you need, and it is not the most important document when planning for health care decisions.
There are three documents to consider: (1) Durable Power of Attorney for Health Care Decisions, (2) Health Care Directive, and (3) possibly a Physician Order for Life Sustaining Treatment (or “POLST”).  Of these documents, the Durable power of Attorney for Health Care Decisions is by far the most important because it will apply anytime that you are unable to communicate.

The Health Care Directive applies in relatively narrow circumstances–end of life where no recovery is expected or in the event of a permanent coma. In those narrow circumstances, it states your preference for the use of various forms of life support. It does not name another person to make decisions for you.

In contrast, the Power of Attorney could apply in many different situations, both temporary and long-term. For example the Power of Attorney could be used in the event of temporary unconsciousness following an accident or a surgical procedure from which you are expected to recover.  Powers of Attorney are also commonly used when a person has a long-term debilitating illness, such as Alzheimer’s and is no longer able to make decisions, but is not yet terminal.

Powers of Attorney usually include the power to make end-of-life decisions concerning the use of life support. The Health Care Directive is helpful because it gives guidance to the person who has your Power of Attorney. The last document, the POLST, is similar to the Health Care Directive, but you complete it with the assistance of your physician and the physician also signs it. Most often the POLST is used when a patient has a diagnosis that is likely to trigger these types of issues at some point in the future. The patient then has the opportunity to discuss these issues with the physician.  Like the Health Care Directive, the POLST addresses end of life issues and is not a substitute for the Power of Attorney that might be needed in situations arising prior to end of life.

Amy Lewis is an estate and tax planning attorney with Eisenhower, Carlson in Tacoma.  Please consult a qualified estate planner before making a gift in your will.