Why a will or living trust isn't enough.

Although a valid will or living trust is essential to long-term planning, it doesn't deal with one of the most important issues facing us as we get older: Who will make medical decisions on our behalf if we are unable to speak for ourselves?

The traditional solution has been to prepare an Advance Health Care Directive. This document has two components: It appoints a representative to make informed healthcare decisions on your behalf; and it expresses in a general way your preferences for your treatment should your condition become terminal.

Beginning January 1, 2009, an important supplement to the Advance Health Care Directive became available in California. The new Physicians Orders for Life-Sustaining Treatment (POLST) form allows you to express specific wishes to a healthcare provider related to end-of-life care. Instead of simply giving broad decision-making authority to your representative in your Advance Health Care Directive, you may now specify particular kinds of treatment that you wish to either receive or not receive. POLST is NOT a substitute for an Advance Health Care Directive (which accomplishes additional purposes), but it does assist in answering some of the most personal and difficult questions about end-of-life treatment.

As with all documents that may affect your life and care, you should discuss its provisions with your physician and family members.