Ever since your late teens and early twenties, you have exercised self-determination about marriage, work, home and politics. Even in healthcare matters, ultimately you decide on your medical treatment after the doctors have informed you of the various options and their recommendations. Moreover, the decision to forego medical treatment is your choice because of this principle of autonomy. You maintain the right to live your life your way, healthy or not, and not according to another person’s opinion, need and wish. This is your life! 
Consequently, you also should inform loved ones and the medical community about your healthcare preferences NOW, not later.
Sincere and direct conversations with your loved ones and healthcare partners are important because they ensure that your medical preferences and goals at any age, albeit 70, 80, 90 and 100 are carried out. And medically speaking, maintaining the principle of autonomy in old age is paramount.
Please, do not assume that everyone knows your health and fitness goals. In fact, it is not uncommon that a doctor advises without knowing his or her patient well enough to judge what the patient would want or do if he or she should suddenly become unconscious from a tragic accident. Have the substantive conversations now about your wellbeing in order that your family members and doctor immediately align the care plan with how you want them to treat your medical issues.
As you know all too well living your life and living healthy are not always compatible. So all those involved with your physical and mental wellness should know your honest answer when the two conflict. It will lead to a more comfortable doctor visit. And even though these conversations about values, lifestyles and particularly the end of life medical issues may be uncomfortable, not discussing the goals of your treatment plan should cause you concern. For example, on the one hand a senior who continues to smoke should not stop seeing their doctor, and on the other hand a doctor should not quit seeking and suggesting alternative approaches for smoking cessation. Keep the channels of communication open and flowing. This ongoing dialogue with those responsible for your current and future healthcare, whether a spouse, significant other, a brother or sister, your children, a doctor, lawyer etc. can alter immensely your wellness now and affect any peace and happiness that you retain as you grow old. It’s your Life!