What is a living will?

A living will is a legal document that specifies what medical care you want to receive if you become incapacitated and can’t make decisions for yourself. Living wills are primarily for detailing your wishes for end-of-life medical care, including when to prolong your life through life support devices or other life-sustaining treatments. Many people create a living will because they have a terminal illness and want to avoid burdening their families as much as possible.

While it may be grim or distressing to think about, planning ahead for end-of-life situations is an important part of estate planning. It can offer you peace of mind and help your loved ones navigate difficult circumstances without having to make difficult decisions that potentially go against your wishes.

A living will is distinct from a last will and testament (commonly just called a will), which is a document that describes who you want to get your belongings after your death.

What is a living will?

A living will is a legal document that specifies the medical care you want to receive in the future if you become incapacitated and can’t make decisions for yourself. Living wills are an important part of advance care planning and an essential estate planning document.

You set the terms of your living will and dictate when it goes into effect. For example, you might specify that the information in your living will applies when you are in a coma or vegetative state, but not when you’re terminally ill or have Alzheimer’s disease.

You may also choose to describe situations where you would accept or refuse medical treatment that is meant to prolong your life. If you want to include directions around specific kinds of treatment, you can do that. As an example, you might specify in your living will that you wish to be removed (or not be removed) from a ventilator — a machine that helps you breathe — if it’s the only thing keeping you alive.

A living will may go by other names, like a medical directive, health care directive, advance health care directive, or instruction directive. Many people call a living will an advance directive, though the term could technically describe multiple forms that deal with health care instructions.

When should you get a living will?

As you get older, and especially if you are already sick or receiving treatment for a health condition, you may want to consider a medical directive. Individuals with a terminal illness should also consider a living will. If you have specific treatments or types of care you know you want to avoid, a living will can help you make those wishes known. Living wills are often simple to create, so there may not be much harm in writing one just in case something happens to you.

Living wills are most useful for scenarios that occur over longer periods, such as deciding whether to begin surgery or treat an illness with a powerful pain medication. In the case of an emergency medical treatment, a doctor may need to make a quick decision about your care, without having time to consult family about whether you have a living will. (This is typically why do not resuscitate orders are completed by your doctor; more on that later.) To help avoid this scenario, inform your doctor and health care providers ahead of time if you have a living will, and give them a copy of it.

What to include in a living will

State laws usually guide what information living wills must contain and your state may even provide a template. You are not required to use your state’s template. You should tailor the contents of your medical directive to your personal wishes, but here are some types of care that are commonly covered in a living will:

• Life-sustaining medical care
• Hospice care and palliative care
• Organ and tissue donation

Life-sustaining medical care

You must decide under what circumstances your life should be prolonged and by what measures. Common life-sustaining treatments include:

• Dialysis
• Intubation (feeding tube)
• Mechanical ventilation (breathing machine or respirator)
• Resuscitation (CPR or defibrillator)
• Blood transfusions

A do not resuscitate order, or DNR order, states that you don’t want your heart to be restarted. You may choose to include a DNR order in your living will, but it may need to be completed by your doctor or medical provider.

To learn more about any of these treatments, consult with your physician.

Hospice care and palliative care

Palliative care (comfort care) focuses on pain management when you’re terminally ill. You can consent to receiving pain medication at all times, even if it accelerates death. You can also state whether you prefer to receive care at home or in the hospital.

Organ and tissue donation

You can choose to make an organ donation for people who need transplants, or donate your body for research or educational purposes. The living will can also state your that your wish is to undergo an autopsy, even when it is deemed unnecessary.

How to write a living will

A living will doesn’t need to be a long document, but remember that if you have specific wishes for your care, your living will is your chance to lay out exactly what you want. You should probably err on the side of including more detail than not enough.

The general process to create a living will is simple and includes four main steps:

• Find your state’s (or a similar) living will template
• Fill out the form to describe your wishes
• Have two witnesses sign the living will
• Get your living will notarized

How to find a living will template

Many states provide free templates for living wills. Look for your state’s form, since it can prevent you from forgetting necessary information. In some cases, an online will service will include help with documents beyond just a last will and testament. The costs to create a living will online vary, so make sure to shop around. It is also possible to work with an estate planning attorney. An attorney can help you create a very strong document, but this is usually the most expensive option.

How to fill out your living will

Whichever template you choose, the next step is to fill it out. Some forms will include boxes that you can mark to say you do or not wish to receive certain treatments. Other forms may require you to write out more information yourself. In that case, the types of information listed in the previous section may be a helpful starting point. Again, be as detailed as necessary to make sure your wishes are clear.

Finally you will need to sign and date the document in addition to adding your address or other personal information.

Have two witnesses sign your living will

Once you fill out the paperwork, two witnesses need to sign the living will. Who is eligible to be a witness depends on your state. Some states may prohibit witnesses that are immediate family or your agents (individuals you name to make decisions on your behalf). Witnesses must also be of a certain age. In Vermont, your witnesses must be at least 18 years old, but in Texas, they can be as young as 14.

Once you fill out the paperwork, the living will generally needs to be signed by two witnesses and notarized.

Living will vs other advance directives

As mentioned earlier, a living will is commonly called an advance directive even though the term "advance directive" may cover multiple types of documents. Two other advance directives you may want are a medical power of attorney and a health care proxy. You may choose to write these in addition to, or instead of, a living will.

Living will vs medical power of attorney

A power of attorney for health care or “health care proxy” allows someone (called a “health care Agent” or an “attorney-in-fact for health care”) to make medical decisions for you when you cannot do so yourself. (Other power of attorney documents may cover financial decisions or other legal situations.)

A living will is mainly intended for end-of-life, whereas medical power of attorney is meant to cover a broader range of medical care. (Both are examples of advance directives.) For example, the person who you granted as attorney-in-fact for health care can make decisions while you are temporarily in surgery, not just when you are in a coma. The agent should follow your living will if you have one.

Living will vs health care proxy

A health care proxy (HCP) also allows you to appoint someone (your agent) to make health care decisions on your behalf when you cannot communicate your wishes. Unlike a living will, a health care proxy doesn’t explain the care or treatments you want. An HCP is typically its own form that’s separate from, but included with, a living will. Many states have their own health care proxy forms written into state law.

What is the difference between a will and a living will?

A last will and testament, often called just a will, is distinct from a living will. A will describes how your personal property and assets should be distributed after you die. A living will provides instructions on how and when you should receive medical care; it doesn’t deal with assets, beneficiaries, or inheritances in any capacity. Both a will and living will are essential estate planning documents that everyone should have.

If all you need is a will, you create one by downloading the Policygenius app and going through the process.

Living will vs living trust

The only similarity between a living trust and a living will is the word “living” in the name. A living trust is simply a trust that takes effect while you’re alive and allows your assets to be distributed to your heirs according to its terms.