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Although great medical interventions have allowed people to live longer and survive difficult diseases, we all must face death sometime. You have choices on what you want or do not want done when you near death, but there are no guarantees unless you plan ahead.

Choices of aggressive treatment versus dying comfortably should be based on your own values and beliefs. It is important to make sure end-of-life discussions and preparations, known as Advanced Care Planning, are done long before a medical crisis occurs.

End-of-life conversations and planning should happen now between you, your loved ones and your health care providers.

Legal documentation

An Advance Directive is written, legal documentation of the decisions made in these conversations that conveys your wishes clearly to loved ones and health care providers. Health care professionals, lawmakers and ethicists encourage people to have an Advanced Directive, yet less than a third of people do.

Not understanding the options and consequences or the fear of death keep many people from completing this important task.

Some Advance Directives are simple and others are elaborate. Either way, they should include two main parts: a living will or health care directive and medical power of attorney or health care proxy.

A living will (health care directive) is a document that outlines your wishes for end-of-life medical treatment. These decisions include whether you want to be kept alive artificially, what level of disability you are willing endure, and how to let you die if you have no hope of recovery.

When you cannot speak for yourself, loved ones must make these difficult and emotional decisions. If loved ones are not available, physicians and health care providers must decide whether to continue medical treatment. This can be very difficult in either case, which is why advanced care planning is so important. It puts the choice in your hands.

A medical power of attorney is a document that names the person (health care proxy), appointed to make decisions about your medical care when you have lost decision-making ability. The person you should appoint is the person who understands your wishes about end-of-life treatments who can convey your decisions to your health care providers when you are unable to communicate.

Not only is your health care proxy extremely important in the absence of a living will, but he or she can also address specific wishes and values that may not be covered in your living will.

An Advanced Directive can ensure your choices are honored and that you experience the highest quality of life and dignity even at the end. Talk to your loved ones and health care providers about your death and dying wishes, so they are not left to blindly make these decisions for you.

Wonderful gift

These conversations and written documents ensure your choices and values are respected and followed, and they are a wonderful gift you can give your loved ones.

More information about Advance Directives can be found on sites like Caring Connections at A state specific Advanced Directive can be downloaded at

More extensive advanced directives can be purchased on sites such as Aging with Dignity. That site’s document, “Five Wishes,” can be purchased for $5 at www.

Mary Kittson is the Director of Home Care and Hospice Services at RiverStone Health. She can be reached at 406.651.6500 or

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