Introductory Guide to Advance Directives

What is an Advance Directive?
If you become unable to make decisions for yourself, an advance directive tells healthcare providers what kind of treatments you do want and what kinds of treatment you don’t want. The directives also provide guidance and peace of mind for family members and friends because your wishes are clearly indicated.

Any person 18 years of age or older can prepare advance directives so their wishes are known in case of an accident or the sudden onset of an illness. Advance directives are typically prepared by people who are terminally or seriously ill.

Advance directives are different in each state and can take various forms. Be sure to check with your state when preparing your advance directives.

Preparing Advance Directives:

  • Get thorough information about the various life-sustaining treatments.
  • Make a decision about what treatment(s) you prefer.
  • Talk to your family and/or healthcare providers about your preference.
  • Use a form provided by your doctor, write down your directives yourself, or talk with an attorney.
  • Follow your state-specific guidelines which can be found at the state health department or state department on aging.
  • Have the document signed by appropriate witnesses or a notary.
  • You do not need a lawyer to prepare advance directives, but follow your state’s guidelines for this document.

Storing Advance Directives:

  • They must be easily accessible and protected from theft, fire, flood, etc.
  • Make several copies and distribute to – your doctors, a trusted family member or loved one, your Durable Power of Attorney for Health Care/ Healthcare Agent, your attorney, and your own files.

Types of Advance Directives:

  1. Living Will – A written legal document which expresses your decisions for medical treatment or life-sustaining treatments in the event you are incapacitated. This document does not let you designate someone to make decisions for you like a Durable Power of Attorney for Health Care form does.
  2. Durable Power of Attorney for Health Care – This document asserts who you have chosen to make health care decisions for you. It is activated when you become unconscious or not able to make decisions for yourself.

Choosing a Healthcare Agent – Because this person will be making significant decisions for you, selecting a person who you trust and who knows you well, such as a family member or close friend.

  1. Do Not Resuscitate Order (DNR)

In-Hospital DNR - This specifies to doctors and hospital staff that you do not want to be given CPR (cardiopulmonary resuscitation) if your heart stops or if you stop breathing. If you tell your doctor prior to being admitted to the hospital that you do not want to be resuscitated, the doctor will put a DNR order into your chart. DNR orders are recognized in all states.

Out-of-Hospital DNR – This document allows a person to specify that in the event that they should stop breathing and their hearts stop beating while in their own home, out in their community, in a medical care facility or hospice setting they do not want to be resuscitated by emergency medical services personnel. The program allows people to declare that certain resuscitative measures will not be used on them.

  1. Organ donor card or form – A driver’s license has organ donor preferences on the back side. You can also fill out an organ donor card or form, downloadable at organdonor.gov.
  2. Funeral plan – A plan for funeral arrangements can take many forms. The purpose if gathering this information is to guide loved ones in planning your funeral and writing your obituary at the time of your death. (See the ‘Funeral Services Planning Guide’ sheet in this packet.)