BOISE, Idaho -- Several times a week, health care workers show up on Tom Thompson's doorstep south of Boise.

A nurse and health care worker make sure that Thompson, 82, is taking the right medications and that his breathing isn't too labored from chronic obstructive pulmonary disease and emphysema.

Thompson won't recover from his disease, and he's already made choices about the end of his life: no artificial means.

Being able to leave detailed instructions is possible thanks to a relatively new and sophisticated approach that is making Idaho one of the most advanced states in the nation for helping residents get exactly the care they want at the end of their lives.

Idahoans now have access to a detailed form approved by the state to be filled out with the help of health care professionals. Once signed by a doctor or nurse practitioner, the document is legally binding. Patients can register the document with the secretary of state, making it available online to any provider.

Thompson got assistance with his form from workers at Boise's Life's Doors Hospice and Home Health Care.

"I don't want to be on life-support garbage," Thompson said. "I don't want to live longer than my kids. I've signed it all."

When many Idaho residents approach the end, they want to know that their wishes for care -- or the lack thereof -- are respected and followed.

For a while, that was a problem. As recently as 2002, Idaho received a D-plus grade from the Robert Wood Johnson Foundation when it came to looking after the wishes of elderly and dying patients.

Until 2007, Idaho offered only the form known as Comfort One, a do-not-resuscitate form. Such DNRs, as they are known, inform doctors and nurses when a patient doesn't want heroic measures to prolong life.

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Idaho leads at helping people die their own way