A living will is a document that states your preferences for medical treatment — or non-treatment — in the event you are medically incapacitated.
Every living will is made up of several ” ,” which provide instructions to your healthcare providers in situations where you are unable to express your own wishes. Also known as advance health care directives (AHCD), these documents are critical for providing you with the level of comfort and dignity you desire any time you are in a serious medical situation.
Just like with a regular last will and testament, you want to carefully consider what you put in your living will. You should talk to your spouse/partner, family members, and other close loved ones about your living will to ensure that they are comfortable with its instructions.
You can also consult with a New Mexico living will attorney to ensure that your advance directives are clearly spelled out and can be enforced on your behalf in a dire medical situation.
Learn more about living wills and other planning options in the event of a terminal illness or extended medical incapacitation when you call New Mexico Financial Family Law at 505-503-1637 or contact us online to schedule a no-obligation case review.
When you attend your appointment with a New Mexico living will lawyer, you are going to have to prepare to make tough decisions about uncomfortable topics.
The entire purpose of your living will is to act in your stead when you cannot voice your own wishes. You want to be certain that it reflects the same choices you would make if you were able to talk to your treating physician yourself.
Decisions to consider include:
Your New Mexico living will attorney can go over all of these considerations with you, along with other important matters to consider, like how to address possible challenges to your preferences.
While these are tough topics to grapple with, the important thing is to prepare for a possible unpleasant future now while you still have the ability to express what you would want to happen in that scenario. Otherwise, you may be leaving your family to make tough decisions, or you may be subjected to forms of treatment you’d prefer to avoid — especially if your likelihood of recovering fully is low.
Technically, a living will can activate at any time.
However, the most common scenarios where it would come into effect include times “when you are unable to make or communicate decisions, and either have an incurable or irreversible condition that will result in your death within a relatively short time or you become unconscious and are not expected to regain consciousness,” in the words of the New Mexico State Bar Foundation.
A living will is a versatile document that can contain many requests or provisions in order to fully and accurately express your wishes.
The New Mexico State Bar Foundation recommends that, at minimum, your living will contains the following instructions for health care:
In addition, you can create other health care advance directives, such as designating a primary physician to oversee your care and a health care attorney-in-fact to help make decisions on your behalf while you are incapacitated.
When writing a living will, consider the following types of care and whether you would like them administered in an attempt to prolong your life:
For short-term situations where the patient cannot eat on their own or where eating is temporarily discouraged, the patient may receive nutrition through an intravenous (IV) infusion containing water and various nutrients.
Longer-term incapacitations will require a feeding tube. The tube may be inserted through the patient’s mouth into the esophagus, or a tube may inserted directly into the stomach by surgery, depending on the expected length of the patient’s incapacitation.
When a patient has difficulty breathing, they will be intubated, meaning a breathing tube is inserted into their throat. The tube is connected to a mechanical ventilator, which provides oxygen while keeping air pathways open.
The patient must usually be sedated while the tube is inserted, as it is uncomfortable and can cause involuntary reactions to remove the tube.
For longer-term incapacitation, the patient may receive a tracheotomy, creating a surgical hole in their trachea so the breathing tube doesn’t need to go through their mouth.
CPR can be rough on the body. Chest compressions can crack ribs and cause lung damage, especially in older patients. Forced ventilation — such as through mouth-to-mouth resuscitation or a bellows — can cause the lungs to rupture and leave other types of severe damage to airways.
Resuscitation can also consist of defibrillation, which can lead to burns or organ damage.
If you prefer not to receive CPR or defibrillation, you can state your preferences in a New Mexico living will. Go over these options with a healthcare professional and your loved one when deciding on the level of resuscitation you would like to receive in an emergency.
Pain management can include the use of non-steroid anti-inflammatory drugs, like Tylenol, or it can involve stronger solutions, like morphine.
Determine what drugs you would feel comfortable receiving and whether you want them to be used temporarily versus as a long-term palliative treatment.
Dialysis is used in patients with failing kidney functions. The patient’s blood is cycled through a machine that filters waste and unneeded fluid, taking over the functions of the failing kidneys.
Long-term dialysis can lead to an increased risk of infection and other complications.
Antibiotics, antiviral medicines, and anti-fungal treatments may be used as a preventative measure for incapacitated patients at risk of developing a serious infection. If an infection does develop, they may receive stronger doses, which can carry side effects of their own.
Palliative care for an incapacitated patient can consist of all of the above measures, along with services like bathing, education to caregivers, muscle palpitation, and social supports for family members.
A do not resuscitate (DNR) order is written by your doctor and given to emergency medical technicians to instruct them to not resuscitate you as part of your care. This document is separate from your living will.
Your living will should directly reference your DNR order and reflect it accurately, with no contradictions.
You can also request a do not intubate (DNI) order from your physician to provide similar instructions in the event your breathing slows or stops.
If you have other specific requests that you want to be issued by your doctor to accompany your living will, you can request medical orders for scope of treatment (MOST). These provide instructions to care management and emergency medical teams in a similar way to a DNR or DNI order.
A living will can designate someone to help make medical decisions on your behalf while you are incapacitated.
This designation is not legally binding in all situations, however, so you may want to accompany it with a power of attorney (POA) document.
Designating someone as your health care attorney-in-fact with a power of attorney document gives them broader abilities to act in your stead. For example, they would have the same level of access to your medical records as you would, along with the ability to consent to certain tests, treatments, or life-prolonging care measures.
You can specify the extent of the powers of attorney, such as by stating a time limit on how long the powers are active. You can also require the attorney-in-fact to refer exclusively to your living will for guidance or give them permission to consult with your family and medical care teams to come to a decision on their own while keeping your stated preferences in mind.
Care providers generally recommend that anyone you designate as your health care proxy or agent should meet the following criteria:
Your living will should be updated on a semi-frequent basis. You should consider revising the document any time you receive a major health diagnosis that is likely to result in a terminal or incapacitating condition.
Also, revise the document any time you have a major change to your family situation, such as a divorce, remarriage, or the loss of a loved one you had intended to act as your medical proxy.
Make sure to review your living will somewhat often (e.g., 5 – 10 years) so you can refamiliarize yourself with your stated preferences and revise them if your intentions have changed.
Yes. Your living will can be revoked at any time in writing or by physically destroying the document.
In some cases, you can verbally revoke the living will, but this request must be verified by witnesses and may be subject to questions regarding your capacity at the time of the request.
You can make multiple copies of your living will. Store the original in a safe place, and give copies to your primary care physician, health care agent (attorney-in-fact), and close family members who you want to have access to your wishes.
You can also keep a copy of your living will, in brief, in your wallet, with instructions to contact your physician and health care agent in the event you are incapacitated.
It can be difficult — but not impossible — for family members to override the preferences for treatment you recorded in your living will. Having a healthcare attorney-in-fact appointed can reduce this risk.
In these cases, the question of who has the authority to make decisions regarding your care could be left to the court. In the meantime, you may receive life-prolonging care contrary to your stated preferences.
To reduce the risk of a dispute among your loved ones — or you receiving care you expressly did not want — make sure to discuss your living will and end-of-life care plans with close family members. Explain your wishes clearly. You can even record the conversation to document your family’s contrary opinion and your insistence that they honor your wishes.
These conversations can reduce the likelihood that your living will’s validity is called into question. Not only that, but it can also reduce your family’s feelings of remorse, guilt, or a desire to contradict your wishes out of their own preferences.
A living will is an important way to express your wishes and advocate for your own values and preferences during times when you aren’t able to represent yourself. It can reduce conflicts among your family members and soothe their worries.
Otherwise, they may wonder what you would want to happen in regard to your own medical care.
Get prepared, and feel more assured that your wishes will be honored when you schedule an appointment at our New Mexico living will law firm. Book a no-obligation consultation today to discuss your options with an attorney when you call 505-503-1637 or contact us online.
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