Living wills and powers of attorney: preparing for the worst

Fate often takes no prisoners: in the wake of an accident or serious illness, you might suddenly be left unable to make your own decisions and look after yourself. With dementia, this situation tends to come about gradually. If you want to be sure that your wishes are taken into account and your loved ones are involved if these kinds of situations come to pass, these documents can help:

• A living will clarifies your wishes in terms of medical treatment and procedures.
• A power of attorney regulates health and welfare powers, the management of your property and financial affairs, and representation in legal transactions.

Our partner, the Swiss Red Cross (SRC), has a living will form and a power of attorney template on their website. Plus, their instructions for the living will form and power of attorney template will help you get to grips with this topic and answer any questions you might have. The SRC also offers consultations, and a chat with your GP can also help you make your decision.

Should your doctors continue performing every medical treatment they can, even if the odds aren’t looking good? What happens to your organs after your death? Would you like to be resuscitated if you suffer a cardiac arrest? A living will gives your relatives and medical staff a sense of what you’d like to happen if you no longer have mental capacity. You can use your living will to set out which treatments, interventions and medical measures you consent to, depending on your state of health, and which you reject. You can also appoint someone to make decisions on your behalf in these situations.

The living will needs to be written, dated and signed. You are free to choose what it contains and what form it takes: you can write it by hand, type it, or simply complete a pre-provided living will form. It does not need to be witnessed.

You can amend or revoke a living will at any time. In addition, you should regularly check that your living will still aligns with your wishes and amend it if necessary.

• Personal details and date of birth
• Confirmation of mental capacity
• Personal values
• The name of your representative and their contact details
• Information about the situations in which the living will should be used
• Details of the goals of treatment in particular situations
• Consent to or rejection of specific medical measures
• Willingness or requests for organ donation
• Details of what you’d like to happen to your body after death
• Date and signature

The original copy of your living will is best kept at home in an easily accessible location. Give a copy to someone you trust and a copy to the doctors treating you. Put a card in your wallet stating where the living will is and who should be contacted in an emergency. Take your living will with you when you go to hospital or on holiday. Plus, you can have the existence of a living will registered on your health insurance card. You can also store it with the SRC, which enables your living will to be easily accessed around the clock.

If you don’t have a living will, the law says the following people make decisions, in this order:

• Spouse or registered partner
• People who cohabit with the person in a joint household, such as cohabiting partners, but not people who simply share accommodation
• Children
• Parents
• Siblings

Family members are only entitled to represent you if they are in regular contact with you. When a patient has no relatives, does not have contact with them, or if they can’t be found or don’t want to make decisions, the Child and Adult Protection Authority (CAPA) will appoint an advisor to make decisions on behalf of the individual.

A power of attorney stipulates who may make decisions in your stead, such as your partner or someone else you trust. It comprises three components:

• Health and welfare powers regulate day-to-day decisions
  Support at home, opening post, maintaining personal correspondence, desired form of care
• Property and financial affairs powers ensure your assets are managed in an orderly way
  Processing of payments, management of income and assets, continuation of business for self-employed workers
• Representation in legal correspondence relating to any legal matters
  All legal interactions with official bodies and other public or private institutions, conclusion of contracts, submission of tax returns, release from medical or official secrecy

The law is strict on this point: a power of attorney is only valid if it is written by hand from start to finish, dated and signed. Handwriting analysis can be carried out in case of doubt.

You can use your power of attorney to set down how you would like all kinds of matters to be dealt with, or you can focus on matters from specific areas.

If you are not able to write your power of attorney by hand, your notary can help. They will certify that the person had full capacity at the point at which it was drawn up and that the content of the power of attorney aligns with their wishes. A fee is levied for this service; prices vary from canton to canton.

If an individual is living on their own, is widowed or cohabits with someone and does not have a power of attorney, the Child and Adult Protection Authority (CAPA) will decide whether an external guardianship is to be arranged or whether relatives will be given the authority to make decisions.

If a person in a marriage or registered partnership loses mental capacity, their spouse or partner can continue to represent them in day-to-day matters. To do so, they must live in the same household or be able to provide in-person support on a regular basis. It is a different situation for legal matters that relate to exceptional issues: without a valid power of attorney, the state will have a say in decisions made, with CAPA authorisation required for this. This includes selling property, increasing a mortgage or accepting or renouncing an inheritance, for example.