At the beginning of the millennium in the year 2000, around 47 percent of elderly people had written a living will. That’s a large number by anyone’s standards (particularly when compared to the general population who have written wills), but just 10 years later, that fairly healthy (in relative terms) figure had rocketed to over 70 percent. What had caused the sudden need for the elderly to write living wills?
There are a number of different suggestions.
In a living will the testator’s wishes regarding their medical treatment can be noted and referred to in the event that they are unable to speak for themselves for any reason. It is the best way to ensure that, should the worst happen, you are taken care of as you want to be. If the will writer were to suffer an illness or accident that leaves them in a permanently unconscious or vegetative state, they can choose what happens to them, and whether any ‘heroic measures’ are used to help them.
One reason that is suggested for the sudden and large rise in living wills being made is that the majority of people would rather end their lives in a hospice or at home than in a hospital – palliative care is the preferred option to medical intervention according to recent surveys. If a life is going to end, comfort and dignity are what is required, not lots of invasive procedures and medication. Having a living will means that you are more likely to get exactly what you want rather than what the hospital thinks should happen.
An upside of this is that society is becoming more and more open to discussing death and dying with friends and family, making it less of a taboo subject. Hopefully the advantage of this happening is that younger people will begin to make their wills earlier, which will mean that probate disputes and dying intestate happen less and less.
The living will has now been replaced by the more secure lasting power of attorney – however, living wills written before 2007 are still valid.
The phrase ‘living will’ rolls off the tongue with ease, and it seems as though script writers enjoy adding it to their murder mystery or FBI investigation programmes with impunity. But although we’re all heard the phrase, and although we might think we know what it means (in terms of the story on TV that we’re watching), there could certainly be nuances that we’re missing.
A living will can also be called a health care directive, advance directive, or physician’s directive. It is similar to a standard will since it is used to write down one’s wishes should something happen – should a specific set of circumstances occur. However, whereas in the case of a standard will that specific set of circumstances is the testator’s death, with a living will it is quite different. As the name suggests, with a living will it is not death that will move the items within it to be carried out, but instead a life that is drastically altered to the one that you were living. If, for example, you were to be involved in an accident that left you alive but in a permanent vegetative state, or a terminal illness that resulted in an end of life coma, the living will could come in to affect.
Not everyone needs or wants to write a living will, but for some the idea of being kept alive solely through machines is a terrifying one, and not something they want to happen to them. A living will will ensure that they are not forced to ‘live’ in such a way. As medical advances continue, death is being pushed further away from many people which, in most cases, is an excellent thing, but when it comes to a case in which death would have been preferable (for the person involved), then the living will can help allow that death to happen.
Through your living will you can instruct medical professionals (at the same time informing your family) that you wish for no ‘heroic measures’ to be taken to keep you alive, and neither do you want any medical intervention including life support machines. The living will can be incredibly specific, allowing you to mention exactly what techniques and medications you would not allow – and the ones you would.
The living will is a way that someone can make their wishes heard when they are unable to speak for themselves. For some, however, the idea of creating such a document sounds like a dangerous thing – what would happen if you were involved in an accident and were unconscious and the living will was invoked even if you could have been saved and gone on to live a perfectly normal life? There is no need to worry about that – the living will is only used when the patient is in a permanent state of unconsciousness. This would need to be certified by medical professionals. Simply being unconscious after an accident would not trigger the living will, and you would be treated as anyone else would in the hospital.
A living will is not something you need to write instead of a standard will; you can have both. However, there is little point in having a living will if no one knows about it – if no one knows it exists, how can anyone action it? So if you do choose to write one, make sure you tell your family about it. Tell your friends. Tell you GP. Tell a solicitor. Make sure that it can be found should anything happen. And make sure that it is drawn up by a professional so that there are no quibbles or questions asked about it. There must be no doubt about what the patient’s wishes are, even if the family does not agree with them.
Presenter and author Joan Bakewell wrote a newspaper article recently, in which she talks about living wills and the need for us to make important decisions about our death and what happens after it, whilst we’re still able.
She states the importance of giving clear, concise instructions as to what you want to happen in the event of your death, in the form of a will. Not doing so, she says, is “seriously neglectful” and could lead to “rancorous squabbles that risk descending through the generations”.
She points out that a will helps you to control what happens to your inheritance and avoid litigation between those you leave behind.
“Living wills” are now known as Advance Directives and indicate such details as what should happen to you, if you become unable to make decisions for yourself through illness or accident.
Joan has prepared hers and filed copies with her doctor, solicitor and family, after discussing the issue with her loved ones. She holds the strong view that a law should be passed, giving greater control to individuals regarding the details of their death and chaired a debate with Lord Falconer in an attempt to open up the discussion.