MINNEAPOLIS - Minnesota stands out in how we handle end-of-life issues.

That's because we have a program like none other in the world right now, a program called Honoring Choices Minnesota which helps people create a health care directive.

Terri Traudt knows the importance of such a document. Her mother, Maxine Beck, passed away last fall.

Beck survived colon cancer but then later grew somewhat dependent on others as she lived with macular degeneration and arthritis.

"She did not want a life of complete dependency," Traudt said.

Beck died of complications from hiatal hernia, her stomach pushing up through her diaphragm, which because of the risks, she chose not to have surgery to repair.

Fortunately Traudt and her siblings knew what her mother

wanted. She had conversations with them a decade earlier about her end-of-life wishes. She had also written up a health care directive.

"I just wonder how my siblings and I would have managed it had we not been all well aware of what my mother's preferences were it would have been really hard," Traudt said.

The Honoring Choices Minnesota program wants everyone to have a health care directive.

"We think all adults should have conversations with their family and loved ones about what medical care they would want if they can't make decisions for themselves," Medical Director Dr. Kent Wilson explained.

Wilson called Honoring Choices Minnesota the only program of its kind in the word, a collaboration of all health systems and plans in the metro.

"We know of no other model that is that extensive and is education based and voluntary," he said.

The goal of a health care directive for every adult because without one, Wilson said, "There can be family feuds that go on for generations over these kinds of issues."

He explained that a health care directive also helps a medical team know when to provide life-saving care or palliative care.

When writing a health care directive, you need to choose an agent. Wilson said this should be a person you trust to carry out your wishes and who would have durable power of attorney for health care. It is the person who will make decisions if you cannot.

He said you should then have conversations to share your values and wishes with that agent, your family and your health care team. Make sure they have copies of your health care directive.

You don't need to pay a lawyer to write up a health care directive. Honoring Choices Minnesota has one on its website for free. All you need is a notary or a couple of witnesses to be there when you sign it.

Traudt said having the health care directive, and more importantly the conversations with her mother about her end-of-life wishes, ultimately made the tough decisions easier.

"Truly honoring someone you love is honoring their choices, not what you want for them, but what they want," she said.

The Honoring Choices Minnesota website has full instructions, in a number of languages, on how to write a health care directive.