Making Plans: Living Wills and Communicating Last Wishes

Advance planning can ensure that your wishes are honored as you reach the end of your life. Most importantly, you should fill out an Advance Directive and a POLST form, if applicable. In an Advance Directive, you will appoint a health care agent or proxy to make decisions for you if you are unable to make them for yourself.

If you have specific preferences about the care you want to receive, or not receive, at the end of life or preferences about where you want to die, you should take the time to document them.

If you appoint a health care agent you should not need a guardianship. If, however, you did not appoint an agent, if your appointed agent cannot serve in that role, or if other complicating factors arise, a court-ordered guardianship may be necessary.


A guardian is appointed by a court after a hearing that establishes the need for a guardian. A court may give a guardian the power to make decisions about your medical care, housing, and other routine decisions. For individuals with few assets, a court may also give the guardian the power to manage your finances. The guardian must make annual reports to the court with respect to the care and status of the ward. Generally the guardian is a family member, if one is available and willing to act. Utah law allows you to nominate a guardian in a written document or as part of an Advance Health Care Directive or Power of Attorney for Health Care.

Expressing End-of-Life Wishes

While most people dying of a terminal illness say they prefer to die at home, some people have other options to consider. Hospice care can be provided in the home or at a nursing home or hospice facility. Some hospitals have separate hospice facilities or provide hospice care in the hospital. In some cases, loved ones may move in during the final weeks or days, or for longer. Determine what options are available to you and express your wishes clearly, to be sure you feel safe and comfortable.

When a patient moves from a regular health care facility to hospice or an end-of-life care facility, there is often a change in health insurance benefits. To avoid unnecessary complications with health insurance companies or Medicare, it’s a good idea to learn their processes and procedures. If you have long-term care insurance, be sure to check those policies to see if there are benefits you can access or rules of which you need to be aware.

Adapted from Utah Commission on Aging Financial Security Guide (2007), published by AARP.