Advance Directive: Care Types, Meaning, Guide

What is an advance directive?

An advance directive is a legal document that provides instructions for your medical care or indicates who can make decisions for you if you cannot communicate. Advance directives include living wills and durable power of attorney designations for health care. The legal standards vary by state.

Types of advance directives

Living wills specify the medical treatment you want — or don’t want — if you’re unable to communicate. They can include preferences for resuscitation, ventilation, feeding tubes, comfort care, and postmortem organ and medical research donations^[0]

Living wills follow a general template, but you can add more detail regarding specific medical situations. For example, if you’re at risk for cardiac arrest and don’t want CPR performed, you can state that in a living will.

This type of power of attorney should be durable, meaning it stays in place if you become incapacitated. Having a proxy is especially helpful if medical standards change or you’re in a situation your living will doesn’t specifically cover^[0]

You may need both a living will and a health care proxy, particularly if you have a non-life-threatening health event.

A combined advance directive document can connect your living will and power of attorney designation with other preferences for comfort and end-of-life processes.

How to make an advance directive

Here are three different ways to create an advance directive.

1. Find a free or inexpensive form. 

   • The American Bar Association compiles links to state-specific advance directive forms.

   • AARP, an interest group for people over 50, and Everplans — a service that helps people organize their essential documents — offer links to free forms for each state. Be sure to confirm with an estate planning attorney that your document complies with the rules in your state^[0]

   • Five Wishes, a website created by the nonprofit organization Aging with Dignity, offers an interactive printable advance directive form, which includes proxy and living will documentation plus added directives for comfort, prayer and burial. A fully online version is available^[0]

   • Prepare for Your Care, an online resource that helps people make medical decisions, offers free forms with clear instructions and specific questions about your quality of life and values^[0]

2. Hire a financial advisor or estate planning attorney. They can help you create an estate plan, including advance directives.

3. Use estate planning software. Make sure the product you choose explains how to make the document legally binding for your state and includes all the possible options you need. Many online will makers include living wills and health care proxy designations with the purchase of a will or trust package.

Here’s what to do once you’ve completed your forms:

1. Sign your documents. Some states require you to sign your forms in front of witnesses to make them legally valid, and in some, you’ll have to get the documents notarized^[0]

2. Give copies to your doctor and health care proxy, plus close family members and your attorney, if you have one. Ask your doctor to add the forms to your electronic health record so other providers can access them in an emergency.

4. You can officially register your advance medical directive in some states, though it’s not required^[0]

How to change an advance directive

You can change your advance directives at any time as long as you’re of sound mind. Here are some tips.

• Create a new document rather than amend the original. Completing a new directive will usually automatically revoke your previous version.

• Update your family, doctor and attorney with the new information and destroy the original documents.

• You can pay a fee to make changes and register a new form if you’ve registered your advance directive with your state.

• Review your advance directive around every 10 years, or if you receive a new medical diagnosis or change your marital status.