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An advance directive is a form that you fill out to describe the kinds of medical care you want to have if something happens to you and you can't speak for yourself. It tells your family and your doctor what to do if you're badly hurt or have a serious illness that keeps you from saying what you want.
There are two main types of advance directives:
As long as you can still make your own decisions, your advance directive won't be used. You can stop or say "no" to treatment at any time.
As you prepare your advance directive, you'll need to follow these four important steps:
You can get the forms in a doctor's office, hospital, law office, state or local office for the aging, senior center, or nursing home. You can also get them online at www.caringinfo.org or by calling 1-800-658-8898.
When you write your advance directive, think about the kinds of treatments that you do or don't want to receive if you get seriously hurt or ill.
Consider whether you want to:
These are tough choices to make, but you don't have to make them alone. Take your time. Share your questions or concerns about what to include in your advance directive with your doctor or nurse, your lawyer, your family, or a friend.
You can change or cancel your advance directive at any time. Just fill out new forms and get rid of your existing forms. Or you can just let your family, your doctor, and your health care agent know about the change. If you change or create new forms, give everyone an updated copy. Don't just cross out or add new information unless it's only to change your address or phone number.
Learning about advance directives:
Things to consider:
Health Tools help you make wise health decisions or take action to improve your health.
An advance directive is a legal form that describes the kinds of medical care you want to receive if something happens to you and you can't speak for yourself. It tells your family and your doctor what to do if you're badly hurt or have a serious illness that keeps you from saying what you want.
The two main types of advance directives are a living will and a medical power of attorney.
A living will makes clear the kinds of medical care you want to receive if you get seriously hurt or ill and can't make your own decisions. It describes your choices for care and how you want them carried out if you're near the end of your life or are in the hospital with a serious illness. If you get better and can speak for yourself again, you can stop or say "no" to treatment at any time. If you have a living will, your choices will be honored. A living will is also called a treatment directive.
A medical power of attorney lets you name a person to make treatment decisions for you when you can't speak for yourself. This person is called a health care agent or health care proxy. Some states may limit what your health care agent can decide for you. In a few states, he or she can speak for you right away and at any time that you don't want to make choices for yourself. He or she can also use your living will and what he or she knows about you to help guide your care.
When you choose a health care agent, select a person you trust to make medical decisions for you. For more information, see the topic Choosing a Health Care Agent.
As long as you can still make your own decisions, your advance directive won't be used. You can change or cancel it at any time. Your health care agent will only make choices for you if you can't or don't want to decide for yourself.
An advance directive is important in case something happens to you and you can't speak for yourself. It gives you control over your own medical care if you're badly hurt or if you develop a serious illness and you can't make your own medical decisions. It's also very important for your family and your doctor. They can use the information in your advance directive to make choices for you if you can't make them yourself.
A living will and a medical power of attorney are the main types of advance directives.
If you don't have a living will and a health care agent, a person other than your family member may decide what kind of care you receive. A decision may be made by a doctor who doesn't know you, or it may even be made by the courts. In some states, you need to make clear and give permission in your advance directive that you don't want to be fed through a tube or receive other kinds of life support.
Sometimes you and your family may need help agreeing on the best way to meet your medical needs. Eldercare mediation can help families work together.
If you've decided to write an advance directive, you've taken an important step to make sure that your health care wishes are met.
When you write your advance directive, think about the kinds of treatments you do or don't want to receive if you get seriously hurt or ill. If you have questions and need help to get started, see what things to include in an advance directive for some ideas.
Involve your family, your health care agent, and your doctor as you write your advance directive so they'll know what you want. If something happens that you didn't plan for, they'll have a better idea of how you would want to handle it.
There are many choices to make when you write your advance directive. Some of these have to do with whether you want certain treatments.
To help you decide which medical treatments you do or don't want to receive, see:
These are tough choices to make, but you don't have to make them alone. Look to your family, your doctor, and your friends for help and support.
As you prepare an advance directive, you'll need to follow these four important steps:
You can change or cancel your advance directive at any time. Just fill out new forms and get rid of your existing forms. Or you can just let your family, your doctor, and your health care agent know about the change. If you change or create new forms, give everyone an updated copy. Don't just cross out or add new details unless it's only to change your address or phone number.
This website from the American Hospital Association has information on writing an advance directive, self-help worksheets, and other resources. The site also offers a brochure ("Put It In Writing"), a glossary of terms, and questions and answers. There is also a wallet ID card that can be downloaded, printed, and filled out to carry in your wallet.
Aging With Dignity is a private, non-profit organization best known for its Five Wishes advance directive, which helps individuals and families better plan for and receive the kind of care they want during times of serious illness. Five Wishes is a document that helps you express how you want to be treated if you are seriously ill and not able to speak for yourself. All of a person's needs are addressed: medical, personal, emotional, and spiritual.
Caring Connections, a program of the U.S. National Hospice and Palliative Care Organization (NHPCO), seeks to improve care at the end of life. Caring Connections provides free resources, including educational brochures, advance directives and hospice information, and a toll-free help line for people looking for quality end-of-life information.
Other Works ConsultedCordts GA, et al. (2007). Care at the end of life. In LR Barker et al., eds., Principles of Ambulatory Medicine, 7th ed., pp. 192–207. Philadelphia: Lippincott Williams and Wilkins.Kinzbrunner BM, Gomez D (2011). Advance directives and CPR at the end of life. In BM Kinzbrunner, JS Policzer, eds., End-of-Life Care, 2nd ed., pp. 521–539. New York: McGraw-Hill.Reichman WE, et al. (2009). Legal, ethical, and policy issues. In DG Blazer, DC Steffens, eds., American Psychiatric Publishing Textbook of Geriatric Psychiatry, 4th ed., pp. 603–617. Washington, DC: American Psychiatric Publishing.
Last Revised: December 29, 2011
Author: Healthwise Staff
Medical Review: Anne C. Poinier, MD - Internal Medicine & Shelly R. Garone, MD, FACP - Palliative Medicine
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