There are some things in life we put off because they make us uncomfortable. Going to the dentist, doing neglected home repair or saving adequately for tomorrow are but a few examples.

When it comes to our own mortality, the challenge is magnified. According to a recent ABCNews poll, about 58 percent of American adults do not have a will or other estate plan. Even more people – nearly 75 percent of adults – do not have an advance medical directive, according to a 2014 study published in The American Journal of Preventive Medicine.

Advance directives are legal documents, such as living wills, in which individuals specify their end-of-life medical treatment decisions. April is recognized as Advance Directives Month and it got me thinking about this topic.

I was recently diagnosed with anemia. While visiting doctors’ offices and undergoing tests to get to the cause of my very low iron readings, a doctor asked me if I had an advance directive. Fortunately, I did. When my husband and I updated our will a few years ago, we also had our attorney complete an advance directive, including a DNR (do not resuscitate) form. But this latest episode got me thinking it would be a good idea to revisit these documents and make sure they are current.

I know that end-of-life decisions are difficult considerations for many families. Some of my own family members will not even discuss drafting a will, let alone Advance Directives and DNRs. But my husband and I feel it is important for us to have these documents in place so that when the time comes our wishes are known and adhered to and avoidable uncertainties aren’t thrust upon our children.

A good friend of mine, John Measel, who serves with me on the AARP Texas Executive Council, tells me of a time four years ago when, during a routine procedure to treat his heart arrhythmia, he nearly died when his heartbeat slowed to three to four beats per minute as a result of anesthesia and had to be shocked back into normal rhythm. He had an advance medical directive and says that all hospitals in his hometown of Tyler now ask patients if they have an advanced directive on file when they are admitted.

AARP State President Charlene Hunter James agrees it’s important to have a plan in place to ease the stress on survivors, particularly when they’re in greatest need of the comfort and love of those closest to them. And she contends that young adults also should be preparing these documents. As she has said, “Things can happen to anyone at any time so you need to start the conversation and start it as early as possible.”

In Texas, an advance directive includes four documents: (1) the Directive to the Physician, which provides instructions as to what life-sustaining treatment you would want if unable to physically or mentally make that decision; (2) the Medical Power of Attorney, which names who would be legally able to make your health care decisions if you are unable to; (3) the “Do Not Resuscitate” (DNR) order for anyone not wishing to undergo life sustaining treatment under certain life-threatening conditions and (4) the Directive for Mental Health Treatment, which allows a person to decide in advance what kind of mental health treatment should be given if unable to communicate those choices.

Any of these documents can be completed independently of the others, although for most people the directive to physician and medical power of attorney are highly recommended. You don’t need an attorney to complete the documents although you may wish to consult with one if you have questions. The documents should be witnessed and notarized, discussed with your physician and family members and copies given to the person chosen to hold your medical power of attorney.

Advance directives are about peace of mind, yours and those who are closest to you. So if you struggle with whether to prepare an advance directive, think of it as an act of love. At the end of the day, it’s really not about us but about those who we leave behind.


Julia Castellano-Hoyt is a member of the all-volunteer AARP Texas Executive Council. She and her husband Don are residents of San Antonio.