An advance directive is a legal document that records your wishes about medical care in the event you become unable to speak for yourself — ensuring that your values and preferences guide your care when you cannot communicate them directly. Despite their importance, fewer than 37% of Americans have completed an advance directive. Medical clinics are the ideal setting for these conversations and documents — your primary care provider understands your health situation and can help translate your values into meaningful medical guidance. This guide explains advance directives and how to complete them.
Types of Advance Directives
Living Will
A living will specifies the types of medical treatment you want or do not want under specific circumstances — such as terminal illness, permanent unconsciousness, or end-stage disease. It addresses decisions about life-sustaining treatment, artificial nutrition and hydration, mechanical ventilation, CPR, and similar interventions.
Healthcare Power of Attorney (Healthcare Proxy)
A healthcare power of attorney designates a trusted person (your healthcare proxy or healthcare agent) to make medical decisions on your behalf when you cannot. This person should know your values and preferences and be willing to advocate for your wishes even under pressure from family members or medical staff. The proxy role is as important as — arguably more important than — the written living will.
POLST (Physician Orders for Life-Sustaining Treatment)
POLST (called MOLST or MOST in some states) converts advance directive preferences into actual physician orders that can be acted upon in any medical setting, including by emergency medical services. POLST is most appropriate for seriously ill patients with clear current preferences about specific interventions.
How to Complete an Advance Directive
Reflect on your values — what quality of life means to you, what circumstances you would consider unacceptable, what matters most to you beyond simple survival. Discuss with your healthcare proxy and family. Complete the forms (state-specific forms are available at caringinfo.org or your clinic). Sign with two witnesses (who are not your healthcare proxy or beneficiaries) or a notary, depending on your state’s requirements. Give copies to your clinic, hospital, healthcare proxy, and keep one accessible at home.
Conclusion
Completing an advance directive is an act of care for yourself and those who love you — ensuring that your wishes are known and honored while relieving loved ones of impossible decision-making burdens during crisis moments. Ask your clinic for advance directive forms and guidance at your next appointment. The conversation takes 30 minutes; its impact can last a lifetime.
FAQs – Advance Directives
Q1. At what age should I complete an advance directive?
A: Any competent adult over 18 should have an advance directive. Serious illness and incapacity are not predictable — a young adult injured in an accident benefits from having their wishes documented just as much as an elderly patient with terminal cancer.
Q2. Can I change my advance directive after completing it?
A: Yes. Advance directives can be updated or revoked at any time while you retain decision-making capacity. Review your advance directive periodically (every 5 years or after significant health changes) and update it to reflect current preferences.
Q3. Will my advance directive be honored in a different state?
A: Most states honor out-of-state advance directives under full faith and credit principles, though laws vary. For patients who travel frequently or have homes in multiple states, completing state-specific forms for each state of residence provides the most certainty.
Q4. Does an advance directive affect my treatment during a non-terminal illness?
A: Advance directives specify preferences for situations of terminal illness, permanent unconsciousness, or inability to make decisions — not routine medical care. They do not affect your treatment for treatable conditions while you have decision-making capacity.
Q5. Who should I choose as my healthcare proxy?
A: Choose someone who knows you well, understands your values, can remain calm under pressure, will advocate for your wishes (not their own preferences), and is willing to have difficult conversations with medical staff. Geographic proximity is helpful but not essential — phone and video capabilities enable remote proxy participation.
