Dear Doctor: Our dad insists that he doesn't want any heroic or extraordinary measures taken if he gets really sick, and he wants one of us children to relay this message to his medical team. Should he have a living will?

Dear Reader: We're verging into legal territory with this question, but as medicine continues to advance in its ability to prolong life, this is an important topic for each of us.

A living will refers to a class of legal document that an individual uses to specify his or her wishes for end-of-life medical care. These documents are also referred to as health care advance directives, or simply advance directives.

The idea of a living will comes up most often among the elderly, but in fact, people of all ages can use this document to state what they do and do not want to be done in the instance of a medical emergency. If the time comes that a person is unable to make medical decisions on his own behalf, then the living will speaks for him.

While your dad is correct that you or your siblings can communicate his wishes to his care team, this can place a significant burden on the family. Despite knowing a loved one's wishes, making decisions with life-or-death consequences is not only a challenge, but can also be emotionally wrenching.

A living will often includes a health care proxy or power of attorney. This allows you to name the person who will communicate your wishes if you should become unable to do so yourself. It's understandably easy for family members to become overwhelmed in the midst of a medical crisis, and to agree to medical procedures or lifesaving measures that the patient would not have wanted.

With a living will to address medical specifics, and a health care proxy to name the person in charge of making decisions, those questions are addressed and a roadmap for treatment -- or for withholding treatment -- is clearly laid out.

What can this type of legal document address?

Everything from a person's wishes regarding resuscitation procedures, ventilation techniques and diagnostic tests, to life-prolonging treatments such as CPR, dialysis, blood transfusion, the administration of food, water or drugs, palliative care and surgery. Some people use their living wills to state their wishes regarding dying at home, donating their organs for transplantation or offering their bodies to science.

Individuals who decide to create a living will often begin by speaking with their families about the scope and specifics of the document they want to create. It's also common to consult with your physician, who can help to explain the choices you have and the decisions you are making.

A living will must be in writing and adhere to the legal requirements of the state in which it is being used. A lawyer can help you to create your living will, but it is not a requirement. Both the American Bar Association and the National Hospice and Palliative Care Organization offer links to state-specific forms.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Are there natural remedies for arthritis? Exercises that could help? My pain is in the upper arms and shoulders.

Dear Reader: Osteoarthritis, the kind that you're describing, is caused by degeneration of the cartilage within a joint. Without the cartilage, one bone rubs upon the other, leading to pain and degeneration of the bone.

Doctors typically recommend nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen and aspirin; acetaminophen; and, more rarely, opiates. But NSAIDs can increase the risk of stomach ulcers and kidney problems when used chronically; acetaminophen at high doses can cause liver problems when used chronically; and opiate medications can lead to addiction. So I can understand your desire to look for an alternative for the pain.

The supplements chondroitin sulfate and glucosamine have been used for osteoarthritis for years. Chondroitin is one of the building blocks of cartilage in our body, so many people naturally believe that taking chondroitin can decrease the pain of arthritis.

A 2015 review of 43 randomized trials compared the use of chondroitin alone or in combination with glucosamine against the use of a placebo. Most of these studies looked at treatment for arthritis of the knees, with some looking at arthritis of the hips and hands. The studies measured pain on a 100-point scale. The use of chondroitin was found to be beneficial, whether with or without glucosamine, showing a small 8-point difference in pain compared with placebo. It didn't ease the stiffness and lack of mobility associated with arthritis, however.

In another study, a randomized trial of 606 patients with pain from osteoarthritis of the knee compared the use of glucosamine with chondroitin against the anti-inflammatory drug celecoxib (Celebrex). After six months, both groups found a greater than 50 percent reduction in both pain and joint swelling. What was interesting about the study was that it took a while for the glucosamine/chondroitin to work. At one to four months, Celebrex was much better at improving pain, but at six months it was no different than the glucosamine/chondroitin combination. So with the use of glucosamine and chondroitin, it is important to be patient.

The supplements MSM (methylsulfonylmethane) and DMSO (dimethyl sulfoxide) are anti-inflammatory agents that have been studied in arthritis of the knees without evidence of benefit, but it's possible they could decrease pain in the joints of the hands. Arnica montana is a plant-based therapy that has some potential in topical use for pain relief, with one study finding a slight benefit for arthritis of the hands. Topical use of capsaicin cream, made from chili peppers, has shown potential as well, specifically for arthritis of the knee. Other natural remedies and supplements, such as fish oil, are touted for arthritis, but their use has not been well studied.

As for exercises, I would recommend physical therapy to increase your range of motion for your shoulder and to help increase your muscular strength. Yoga, Pilates and tai chi can also be beneficial, potentially increasing your range of motion without undue stress on your already aching joints. Over time, you may well see a difference in your ability to function with less pain.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I'm 63 years old, and even though my kids think I'm too old, I want to start running. Can you help me to prove them wrong?

Dear Reader: At the risk of wading into the middle of a family argument, we believe that it's never too late to become physically active. And if you're careful about how you begin -- and maintain -- your new exercise regimen, there's no reason why running can't be at least one part of the program.

To get your kids on board, let's start with all the good things that come from regular exercise. And when we say exercise, we're referring specifically to activities like walking briskly, jogging, running, swimming laps, dancing, raking leaves (you get the idea) that will increase your heart rate and breathing for an extended period of time.

Regular exercise can help you to control your weight, reduce your risk of serious health problems like heart disease, Type 2 diabetes and some cancers, and even improve your sleep and your mood. It also strengthens muscles and bones, which not only makes it easier to perform everyday tasks and activities, but also can help with balance and thus reduce the chance of a fall. If you're an older adult, regular exercise increases your chances of living longer.

To succeed at your new running program, you'll need to be smart about the way you get started. We believe it's always wise to enlist your primary care physician as your partner when making this kind of lifestyle change. She or he knows your health history and will be able to flag any potential risks or problems.

As for running itself, there are several things you can do -- must do, really -- to make a go of it. Before you even take your first step, be sure you have the right shoes. They'll not only cushion your step, they will also help with alignment and guard against knee, hip and ankle pain. Good socks and comfortable exercise clothes are also important.

Although your goal is running, you're best off beginning with a long, brisk walk. You'll be surprised at how quickly your heart rate goes up. Plan a route -- 20 minutes is reasonable to start -- and see how it feels. As the days and weeks go by, you can increase both pace and distance. When you're ready, start mixing a few minutes of running into your brisk walk.

Easing into a run-walk routine will help you build strength and allow your body to adjust to the physical impact. As with any physical activity, include a slow warm-up and a deliberate cool-down.

Some of our patients find that having a goal to train for, like a 5k charity run, helps them to stick to their routine. Others prefer the camaraderie of exercising with a class or a friend. The main thing is balance. Don't try to do too much too quickly. And whatever you choose, have fun.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)