🕊️ Leaving Well: A Step-by-Step Process
Facing our own mortality is one of life’s hardest challenges. Still, end-of-life planning is one of the greatest gifts we can give our loved ones.
Thinking ahead helps ensure that our last days are peaceful, dignified, and lived according to our wishes — not someone else’s best guess.
Most of us hope to die at home, in familiar surroundings, and with family nearby. Few wish to spend their final moments in an ICU or emergency room, surrounded by machines and strangers. That vision of comfort and peace is possible — but only through thoughtful advance planning.
Why Planning Ahead Matters
End-of-life decisions are deeply personal. They involve defining what makes life worth living and identifying when medical interventions might take away dignity instead of adding time.
Without planning, others may face impossible choices. The story of Terri Schiavo, who spent 15 years in a persistent vegetative state without written directives, shows how painful this can be. Her family and husband battled in court over her care — a conflict that could have been avoided with documented wishes.
Since then, laws nationwide (including in Maine) have encouraged individuals to create advance health care directives— written instructions that ensure your voice is heard even when you can’t speak for yourself.
Step 1: Appoint a Health Care Agent
If you’re 18 or older, choose a trusted person to make health care decisions on your behalf. This person, also called a health care proxy or agent, should:
Know your values and beliefs
Stay calm during emergencies
Communicate clearly with medical providers
Talk openly with them about your wishes. It’s not an easy conversation, but helpful tools like The Conversation Project Starter Kit can make it easier.
Step 2: Create a Health Care Power of Attorney (HCPOA)
Once you’ve chosen your agent, formalize that choice with your attorney.
A Health Care Power of Attorney (HCPOA) gives your agent legal authority to speak for you if you become unable to make decisions yourself.
Step 3: Add a HIPAA Authorization
Your agent needs access to your medical records to make informed choices.
A HIPAA authorization allows doctors and hospitals to share necessary information with your designated proxy. Without it, your agent may be blocked from critical updates or unable to advocate effectively.
Review your HCPOA and HIPAA documents every five years to ensure they reflect your current wishes.
Step 4: Prepare a Living Will (Physician’s Directive)
A Living Will expresses your preferences for care when quality of life declines or recovery is unlikely.
It clarifies whether you wish to receive life-prolonging measures — such as CPR, ventilators, or feeding tubes — if you are permanently unconscious or terminally ill.
This document can also relieve your loved ones from making those decisions. In Maine and most states, Living Wills are legally recognized. Always complete one with the help of an attorney to avoid errors or misinterpretation.
Step 5: Consider Specialized Directives
Certain conditions, like dementia or neurological diseases, may require additional documents.
For example, someone with advanced dementia can choose to decline hand-feeding when they no longer recognize loved ones or can’t move or speak. This protects against unsafe feeding and unnecessary suffering.
If you have ALS, Parkinson’s, or another chronic illness, your preferences may differ. Some individuals choose to continue treatments that maintain comfort and connection.
Your attorney can help create specific directives tailored to your situation, using trusted resources like End of Life Washington or End of Life Choices New York.
Step 6: Complete a POLST or MOLST
A POLST (Physician’s Orders for Life-Sustaining Treatment) or MOLST (Medical Orders for Life-Sustaining Treatment) is a short-form document for patients who may die within a year.
It tells emergency responders and hospitals whether to perform CPR or other interventions.
Your doctor should help complete this form, which is recognized statewide and should be kept where responders can easily find it — such as on your refrigerator or bedside.
Step 7: Make Your Wishes Known
Planning is only effective if your documents are accessible.
Give copies to your agent, your attorney, and your healthcare providers.
Keep one in your medical file and display emergency forms prominently.
By taking these steps, you give your loved ones clarity and yourself peace of mind. You’ll have done your best to ensure a good death — one that’s meaningful, merciful, and aligned with your values.
At Aging in Maine, we guide individuals and families through end-of-life planning in Maine, ensuring your documents are valid and your wishes honored.
đź“ž Call (207) 848-5600Â to schedule a confidential consultation.
