Planning Ahead for Your Health

Planning Ahead for Your Health

Are you not very strong-minded when it comes to handling your healthcare needs? Or perhaps you just don’t know what you want in the event of an emergency or end-of-life situation? Take heed of this sobering statistic: One in four older Americans say that they -- or a family member -- have endured excessive or unwanted medical treatments. That’s 25 million Americans who’ve undergone procedures, received medications, and/or had medical tests they would have preferred not to have -- a situation more likely to happen when you haven’t made or can’t make your wishes known. By planning ahead you can avoid becoming this statistic. 

It’s a tough topic to discuss, and that probably explains why only one in four Americans has an advance directive: the two-part protection plan for living life your way (and that probably explains why so many folks get treatment they don’t want). An advance directive (AD) includes a living will that lets family, friends and healthcare practitioners know what types of medical care you want and don’t want in a health crisis. It also contains a healthcare power of attorney that designates a relative or friend to carry out your wishes if you can’t speak for yourself.

Advance directives aren’t just for older people. Every adult needs one. In one 2010 study from Johns Hopkins Bloomberg School of Public Health, 60% of adults age 18 and older said they want their wishes respected in a health crisis or at the end of life. Yet just 30% of them had an advance directive. If you’re in that group, what are you waiting for? Maybe you just don’t want to think about it, or feel squeamish about discussing it with loved ones. Perhaps you assume your family or doctor will just know what you want. Or maybe you’re not sure how to create a plan that will really protect you from unwanted medical care -- and give you the care that matters to you when you need it most.

These four steps can help:

  1. Think about it, and then talk it over with your partner, loved ones or a close friend. Start talking about what you want and don’t want in a life-threatening health crisis. You can think about options like artificial breathing, artificial feeding, having your heart re-started if it stops or other such measures. If you’re thinking, “Hey, Doc, I may want one thing at 35, but something else when I’m 105,” you’re on to something. It’s a good idea to revisit this conversation and update your living will from time to time to reflect what’s important to you.
  2. Find help online. One good resource that can help steer you through this conversation is the Five Wishes workbook developed by the Robert Wood Johnson Foundation ( You can order it or use the online version. It meets legal requirements for advance directives in 42 states and applies to all 50 when it comes to choosing a healthcare proxy. You don’t need a lawyer, but having one could help make sure you cross your Ts and dot all your Is. And you will need a witness to sign the papers.  
  3. Make it official. Advance directive rules vary a bit from state to state. Find out what your state requires at Caring Connections (, a website sponsored by the National Hospice and Palliative Care Organization. Their Web site also offers advice about discussing your plans with your family (including what to do if loved ones disagree with you) and turning those plans into an advance directive.
  4. Hand out copies to the right people. These include your doctor, the person you’ve appointed as your healthcare proxy, family members, close friends and anyone else who may be caring for you. Remember: your health, your way.

Medically reviewed in January 2020.

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