Advance directives support your right to die and death with dignity. With an advance directive, you can express how much or how little you want done for you when you are no longer able to make these decisions.

Living wills and other advance directives are written, legal instructions regarding a person’s preferences for medical care if you are unable to make decisions for yourself. Advance directives guide choices for doctors and caregivers if you’re terminally ill, seriously injured, in a coma, or near the end of life.

By planning ahead, you can get the medical care you want, avoid unnecessary suffering and relieve caregivers of decision-making burdens during moments of crisis or grief. You also help reduce confusion or disagreement about the choices you would want people to make on your behalf.

A study published in the Journal of Public Health revealed that more than 60% of individuals aged 18 years and older want their end-of life wishes to be respected; however, only about a third of them had completed advance directives. And about a quarter of those who did not have an advance directive said they did not know about them.

Types of Advance Directives

Advanced directives come in a variety of forms. The names and structure of these tools vary from state, but they do, for the most part, function in similar ways. The forms listed here are a list of the most common directives used today.

• Durable Power Of Attorney for Health Care – (or Medical Power of Attorney): This legal document allows you to select any person to make medical decisions for you if you should become temporarily or even permanently unable to make those decisions for yourself. Most people choose a family member, a relative, or a close friend as their surrogate decision maker.
• Durable Power of Attorney for Asset Management – This form cannot be used to make health care decisions. A Durable Power of Attorney for Asset Management allows an individual to appoint another person to act for them in financial matters. The financial matters could include writing checks, opening and closing accounts, selling stocks and even selling property.
• Declaration for Mental Health Treatment – This document allows you to make decisions in advance about mental health care related to three specific mental health treatments: psychoactive medication, convulsive therapy and emergency mental health treatment. The instructions that you include in this declaration will be followed only if a court believes that you are incapacitated to make treatment decisions.
• Do Not Resuscitate or (DNR) is a legal order written either in the hospital or in a community setting (nursing home, assisted living, living at home) to withhold cardiopulmonary resuscitation or advanced cardiac life support, in a case where a person’s heart was to stop or they stopped breathing. The DNR request is usually made by the patient or health care power of attorney asking the medical team to allow a “natural death”
• Provider Orders for Life Sustaining Treatment (POLST) –  a signed medical order form that communicates the patient’s end-of-life health care wishes to other health care providers during an emergency.

Many people may think drafting an advance directive is complicated and expensive and requires a lawyer. But this is not the case. In fact, many forms are available at no cost and can be completed in the privacy of your own home. Forms for every state are widely available on the Internet. However, you may want to consult with a lawyer just to make sure your advance directive is in order.

Resources

• National Hospice and Palliative Care Organization
• National Healthcare Decision Day
• National Association for Home Care and Hospice

This article has been updated November, 2023.