The first wills we had were executed after our son was born. The motivation to prepare wills was our desire to specify who would assume his care should both of us die. We were living in a small town in North Dakota and hired a local attorney to draw up the document. It cost hundreds of dollars when we didn’t have many extra dollars. However, executing the wills gave us some peace of mind.

When we adopted our daughter, the judge asked us specifically about how she would be treated in our wills, and we wanted her treatment to be the same as her brothers. We wanted them to share equally in any financial resources we would leave. We immediately revised our wills to include her. The same lawyer prepared the revisions, and the bill was again hundreds of dollars. I did not understand why the charge to add her name in a couple of places cost more than drafting the original wills, but we wanted to have the paperwork in place.

Those wills served us for the years our children were growing up. The next time we had wills drafted, they were adults. Custody was no longer an issue. Our lives had changed. We had a few more financial resources. There might be something left when we die. We also provided care for my mother in our home, and Susan’s father was living in a retirement community near our house. New concerns meant new documents. Custody of our children was our primary concern in the first wills we had drafted. This time, the critical document in my mind was the durable power of attorney for health care decisions. I wanted to have a family member make care decisions should I become incapacitated. The new documents sported quite a bit of legal jargon, and we spent quite a bit of time reading them and trying to figure out what they meant.

By the time we had those documents drafted, living wills were common. A living will, also known as an advance directive for health care, outlines a person’s preferences for medical treatment in the event that person becomes unable to make decisions for themselves. It specifically addresses CPR, ventilators, feeding tubes, and other medical procedures and devices used in end-of-life situations. We executed living wills as part of the process.

Shortly after we executed those legal documents, our church had a program where members were given copies of a legal document written in plain English that helped them make their wishes known. The Five Wishes document is a simple form that provides users with some language and allows them to enter their specific issues. The five wishes are:
The person I want to make care decisions for me when I can’t
The kind of medical treatment I want or don’t want
How comfortable I want to be
How I want people to treat me
What I want my loved ones to know

Washington has a similar simple document called Portable Orders for Life Sustaining Treatment (POLST) that an individual and their physician can execute.

My work with families in the church and community taught me a few things about all of these documents. First, many medical situations cannot be imagined when executing the documents. The document assumes that there will be a time when it is known that the end of life is near. However, families frequently find themselves in positions where they don’t know whether or not the end of life is near. A decision about a surgical procedure often involves unknown consequences. The procedure might extend one’s life, and it might not. Quality of life might be greater or lower after a procedure.

My wife suffered two cardiac arrests on the same day while hospitalized. Either event could have resulted in the end of her life. However, the care provided by the hospital, which included the use of CPR and a ventilator, resulted in her being able to recover and resume her normal activities. We are delighted by the results but did not know the outcome, and she could not make decisions.

We are now retired and have had a law firm specializing in elder law draft new wills, powers of attorney for health care decisions, and living wills for us. The process has been frustrating because of all of the legal jargon and because there is no obvious connection between the cost and the required amount of work. We had to prepay to have the work done without knowing how long it would take or how many drafts would be necessary.. Our documents are pretty simple. The first drafts were templates into which a legal assistant had added our specific information, requiring no professional time from the attorney. There is no connection between the amount of work performed and the amount of money charged.

Furthermore, the living wills are documents designed to prevent hospitals from lawsuits, rather than expressions of our desires. We were told that we could not change some of the provisions of the documents. I know from experiences with many families in hospitals that living wills often do not come into play when making medical decisions. Families are rarely consulted about whether or not to put an individual on a ventilator. They are consulted only after the fact when deciding whether to withdraw the ventilator after it has already been inserted.

The most important aspect of the legal work we are having done is not the fancy documents but rather the conversations they have inspired. We have had conversations with each other and with our children about the care we want. I have complete trust in them to make decisions for me, and I am confident that they will not conflict when making decisions. I have already designated my wife and both of our children as being able to access medical information with all of my health care providers.

We have the paperwork in order, but when the time comes, people will always be more important than paperwork.