Only about one-third of American adults have any form of advance directive, according to a Kaiser Family Foundation survey — including among adults over 65, where the percentage is higher but still a significant minority. When someone without a living will is hospitalized and unable to communicate, family members are left making irreversible medical decisions under extreme emotional stress, often without knowing what the person would actually have wanted. Families have been torn apart by these situations. A living will, which takes an afternoon and costs nothing if you use a state-provided form, eliminates almost all of that.
A living will is a legal document that tells doctors what medical treatment you do or don't want if you become incapacitated and can't communicate. It's part of what's known as an advance directive — a set of instructions you leave in advance.
What a Living Will Covers
A living will typically addresses:
- Whether you want life-sustaining treatment (such as a ventilator) if you are terminally ill or in a permanent vegetative state
- Your wishes about resuscitation (CPR)
- Whether you want artificial nutrition and hydration (feeding tubes)
- Your preferences for pain management and comfort care
- Organ and tissue donation wishes
It does not cover financial decisions — that's a separate document called a Power of Attorney.
How It Differs from a Healthcare Proxy
A living will tells doctors what you want. A healthcare proxy (also called a healthcare power of attorney or healthcare agent) names a person to make decisions on your behalf. Many people have both — the proxy can interpret your living will and handle situations it didn't anticipate.
Why It Matters for Your Family
Without a living will, medical decisions fall to family members — who may disagree with each other, may not know your wishes, and who are already under tremendous emotional stress. Families have been torn apart by these situations. A living will removes the guesswork and the burden.
"The most loving thing you can do for the people who care about you is to write down your wishes while you still can."
How to Get One
Requirements vary by state — most require the document to be signed in front of witnesses, and some require notarization. Options for creating one include:
- An attorney: The most thorough option, especially if your situation is complex
- Your state's health department: Many states provide free official forms
- Your doctor or hospital: Healthcare providers often have advance directive forms on hand
- CaringInfo: A program of the National Alliance for Caregiving that provides free, state-specific advance directive forms
- AARP: Offers free printable advance directive forms by state
Once completed, give copies to your doctor, your healthcare proxy, and a trusted family member. Keep the original somewhere accessible — not locked in a safe deposit box that no one can reach in an emergency.
What Happens Without One
Without a living will, if you are hospitalized and unable to communicate, medical decisions default to whoever is present — usually a spouse, adult child, or other family member. When family members disagree, or when they simply don't know what you would have wanted, the results can be both medically uncertain and personally devastating.
In some cases, families push for aggressive intervention — ventilators, feeding tubes, repeated resuscitation — not because it reflects the patient's wishes, but because they can't bear to do otherwise. In other cases, families may be forced to make irreversible decisions under extreme stress, without clear guidance. Either way, the burden falls on the people who love you most.
Courts can be asked to intervene in the most extreme situations, but this takes time, money, and emotional toll — and it still may not produce an outcome that reflects what the patient would have chosen. A living will eliminates almost all of this.
POLST and MOLST: A Different Kind of Document
Alongside a living will, some people — particularly those who are seriously ill or elderly — benefit from a POLST (Physician Orders for Life-Sustaining Treatment) or MOLST (Medical Orders for Life-Sustaining Treatment), depending on the state. The exact name varies, but the concept is the same.
While a living will is a legal document that expresses your wishes, a POLST is a set of medical orders signed by a physician — meaning it can be followed immediately by emergency responders and medical staff without additional steps. It typically addresses CPR, hospitalization preferences, and the use of artificial nutrition.
A POLST is especially relevant for people with a serious illness or advanced age who have specific, immediate preferences about emergency treatment. It's not for everyone — but if you or a loved one has a terminal or chronic serious condition, ask the treating physician about whether a POLST is appropriate. It works alongside a living will, not instead of it.
Having the Conversation with Your Family
Writing a living will is step one. Making sure the people around you understand what's in it — and why — is just as important.
These conversations are uncomfortable, but they are far less painful than the alternative. When discussing your wishes with family, consider:
- Explaining not just what you want, but why — so your proxy understands the values behind the choices, not just the checklist
- Being specific about situations that matter to you (e.g., "I don't want to be kept on a ventilator indefinitely if there's no reasonable chance of recovery")
- Naming your healthcare proxy and making sure that person is willing and able to advocate for your wishes, even under pressure
- Telling your doctor where the document is and making sure it's in your medical file
The American Bar Association offers a free workbook called My Health Care Wishes that helps guide this conversation with family members.
Reviewing and Updating Your Living Will
A living will isn't a set-and-forget document. Your wishes may change over time, and the document should reflect where you are now — not where you were five or ten years ago.
Consider reviewing your living will after any major health change, after the death of a named healthcare proxy, after a divorce or significant change in family circumstances, or simply every three to five years as a matter of habit. Some states have rules about how often advance directives must be renewed; your attorney or state health department can clarify the requirements where you live.
Keep the original in a place that's accessible — not a locked safe or safe deposit box. Many people keep it in a clearly labeled folder at home and give copies to their doctor, their proxy, and one or two trusted family members. Some hospitals and health systems also offer advance directive registries where you can store a digital copy.
There Is No Wrong Time — But Sooner Is Better
Living wills aren't just for the elderly or seriously ill. Accidents and sudden illness happen at any age. Having a living will in place before you need it is the whole point. The same principle applies to all your estate planning — understanding whether you need a will or a trust to protect your assets is a conversation best had before a crisis, not during one.