For many Americans, it was the Terri Schiavo case that raised awareness regarding end-of-life—and the myriad moral, political and medical issues it affords. Owing in large part to an overly zealous media, we know the heart-wrenching story of the woman in her twenties who spent 15 years in a senior care facility in a vegetative state until the Supreme Court—14 appeals, numerous motions, petitions and hearings later—had to decide that Schiavo would not have wanted to continue existing on life support. Terri's husband had won his battle to have her feeding tube removed while her parents mourned what they considered the killing of their daughter. The situation would have been drastically different if Terri had designated either her parents or her husband as her health care proxy. And this was a point that was driven home to many during the media storm that enshrouded the Schiavos and her family.

Proponents of living wills argue that a very high demand is made of friends and family members during an already taxing time if the person in question has not made their intentions and wishes both clear and legal. It's not a long and complicated process either, so don't let that deter you—the actual time spent on drawing up advanced directives is fairly minimal. However, many people are reluctant to consider their own mortality, and it can be decidedly unpleasant to broach the topic with loved ones.

Find a Voice with Advance Directives
An advance directive speaks for you, should you ever become unable to make decisions in the event of a serious or terminal illness and you can no longer communicate on your own behalf. Advance directives, which are also called health care directives, tell your doctor the type of care you want to receive. Advanced directives can tell your doctor whether or not you want life-saving treatment, regardless of how ill you become. There are a few types of advanced directives: living wills, durable powers of attorney, and do-not-resuscitate orders (DNRs).

Living Wills Explained A living will has nothing to do with a conventional will or trust designed to distribute possessions and property after a person's death. A living will is a legal document outlining the kind of medical treatments you would want if you were seriously or terminally ill, and unable to make the decision yourself due to incapacitation (e.g., a coma). It does not allow you to choose someone to make these decisions for you. As such, a living will can be contested if the person who drafted it is not considered to have been mentally competent to make the decisions outlined in the living will.

Cost is a two-pronged factor in living wills. For some, a living will is another way to protect the assets in a conventional will, by ensuring costly measures are not invoked in specific medical situations. Someone who is very near death may not want his or her hard-earned life savings—;oftentimes intended as security for surviving loved ones and friends—to go solely to his or her medical expenses. Five Wishes is an easy-to-comprehend living will form that addresses all of a person's needs: personal, emotional, spiritual and, of course, medical. The Five Wishes living will is currently valid in forty states.

Durable Power of Attorney Explained
A durable power of attorney is a document that authorizes another person to handle any combination of financial, legal and health care decisions on your behalf. If a power of attorney addresses medical or health decisions, it is also called a medical power of attorney or health care proxy. In the document, you name a person to make health care decisions should you fall unconscious or otherwise be unable to make medical decisions. Obviously, your health care proxy or agent in a medical power of attorney should be someone you trust and someone who will respect your wishes even if he or she meets with disagreement from others. Naming a person to act on your behalf is optional; physicians are still bound to follow your written wishes as outlined in your living will.

The Difference between Living Wills and Durable Power of Attorney
A power of attorney document doesn't necessarily state what type of treatment you want to receive in the event of your incapacitation, whereas a living will does. Having an appointed agent is advantageous, because it means that that person will ensure that your written medical wishes are met and can also act as your advocate. Most living wills apply only to permanent unconsciousness or terminal illness, whereas a power of attorney may cover any health care decision and is not limited to terminal illness or permanent unconsciousness. Both of these advance directives are legal in most states. However if they aren't legal in your state, writing down your wishes and assigning a person who you trust to be your advocate will help guide your doctor and loved ones if you can't make the decisions yourself.

DNR Orders Explained
A third type of advance directive is a do-not-resuscitate (DNR) order. Hospital staff is required by law to try to help all patients who have stopped breathing, or whose heart has stopped—unless given instructions to the contrary. A DNR order is a written order from a doctor not to attempt CPR on his or her patient under these circumstances. A DNR order can be written in an advance directive, or via a durable power of attorney. Oftentimes patients with terminal illness ask physicians to sign a DNR order upon hospital admission to help ensure a more natural death without painful or invasive medical procedures. DNR orders are accepted in all states, although the guidelines vary by jurisdiction.

How Do I Get an Advance Directive?
Advance directives—living wills, powers of attorney and DNR orders—need not be complicated documents explaining what you'd like to have happen, or not, if you are unable to speak for yourself. You don't need a lawyer to draft an advance directive; however, they can help ensure that what you've written is as you intended. Notarizing your directives if possible and giving copies to family members and your doctor are additional steps recommended by Medicine Net.

Other resources for drafting your health care directives include:
• 5 Wishes is a simple to complete and affordable way to outline your wishes. Five Wishes provides documents that address personal, emotional, medical and spiritual needs. If you are unable to speak for yourself, you will have already chosen the person you would want to make your health care decisions.
• The National Hospice and Palliative Care Organization provides free advance directive forms for each state. Choose your state and print out a form.
• Ask your physician for advice regarding forms.
• Contact your state's department on aging.

Make Certain Your Health Care Documents are Legal
The following criteria need to be met to ensure a health care directive's legality:

• You must be 18 years old and able to understand the document and its implications.
• You must sign your order, or have another person sign them in the event you are unable, in front of a witness or notary public.
• Must conform to any state or county specific laws; check with a lawyer if you worry about your wishes being contested.

Advanced health directives are not an issue we normally confront until we find ourselves or someone we love in a difficult situation. However, planning ahead can ensure your wishes are met on your own terms. By taking a little time to think about what you really want for yourself and your loved ones, you just might just achieve true peace of mind. An article published by the Journal of the American Geriatrics Society illustrates the importance of these documents. In a recent survey put forth to families of some 1,500 people who died—71% of whom had advance directives—"families felt better about their communication with their loved one's doctor when there was an advance directive. They also felt they were more informed about what to expect during the dying process." Interestingly, patients with advanced directives were more likely to die in a hospice environment rather than in a hospital or intensive care unit.