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The law has a lot to say about personal decision-making. For example, people have the legal right to make their own health care decisions. However, poor health can jeopardize people's ability to defend their legal rights. Safeguarding these rights requires advance thinking and planning. Sudden or chronic illness can cause profound weakness and confusion, which makes people vulnerable and can lead to the unwilling loss of control. Conducting personal affairs, making wishes known, and making sure those wishes are respected may be impossible for people who are physically or mentally impaired. Nevertheless, adults of any age can take steps to protect themselves against losing control over their life, and such steps are especially important for older people.

For health-related personal matters, the key planning tool is a health care advance directive, which includes both a living will and a durable power of attorney for health care. For financial and other property matters, the key legal planning tools are a durable power of attorney, a revocable trust (or living trust), and a will. Together, these legal tools help direct family, friends, health care practitioners, and the legal system so that decisions affecting health care, personal affairs, and property management and distribution are made in accordance with a person's wishes.

The legal system in the United States operates on federal, state, and local levels. State law and especially federal law dictate how property is taxed when it is given away, either while the owner is alive or after death. Federal law controls Medicare, a program that provides health care coverage for most people aged 65 and older. State laws determine how people can direct their own care if they become incapacitated. Under broad federal guidelines, state laws also determine who is qualified for benefits under Medicaid, a program that provides health care coverage for some of the poor and disabled. In addition, state laws control property distribution if a person dies with no will or trust. Because state laws differ significantly, it is important to seek an attorney's advice concerning property matters. Regarding health care matters, people can take many steps on their own and can enlist the help of their doctor, nurse, or social worker. A living will or a durable power of attorney for health care can be prepared without an attorney. However, an attorney may be helpful, especially if a person's wishes are complex or family members are not likely to be in agreement. Complex financial documents should be written by an attorney.

Legal Terms Related to Health Care Legal capacity (competency): The right to manage one's own affairs (bestowed at age 18 in most states). Legal incapacity (incompetency): The inability to manage one's own affairs because of injury or disability; declared by a court of law. Clinical incapacity: The inability to make appropriate decisions regarding health care or to carry them out, as determined by a doctor or other health care practitioner. Advance directives: Documents in the form of either a living will or a durable power of attorney for health care. Living will: A document, sometimes called a directive to doctors, that expresses a person's wishes regarding future medical interventions when the person can no longer communicate those decisions. Durable power of attorney for health care: A document that allows people to designate someone else to make medical treatment decisions on their behalf. Also called a proxy.

Last full review/revision October 2007 by Charles Sabatino, JD