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Tips & Tricks From Our Team: Creating an Advance Directive




About this series: Our Duos have learned countless tips and tricks of the trade in our work supporting older adults and their caregivers. In these posts, we share our easy-to-follow guides for dealing with some of the most common aging navigation issues we encounter every day.

While you may be familiar with the concepts of a will or an estate plan (a set of instructions detailing what your family and friends should do with your possessions if you become ill or after you pass on), many older adults are less familiar with advance directives. While estate plans focus on material assets - your home, bank accounts, and belongings, for example - an advance directive outlines your preferences for your medical care and well-being if you are unable to make those decisions for yourself.

What is an advance directive?

Advance directives are meant to be completed by persons of all ages in preparation for unforeseen end-of-life decisions, like becoming terminally ill or unconscious and unable to communicate instructions themself. While medical professionals will tell individuals what options are available to them based on their medical condition, you always have the right to continue, refuse, or stop treatment or care. An advance directive is an umbrella term that includes two main parts: 

  • A living will - A documented list of medical intervention preferences should you become incapacitated for any reason and are unable to make medical decisions for yourself.
  • Durable Power of Attorney in Health Care - In the case that you are unable to make medical or health-related decisions for yourself, this appoints an individual (18 years of age or older) to make those decisions on your behalf. This may also be known as Medical Power of Attorney or Healthcare Power of Attorney.

Why are advance directives important?

Every individual has a legal right to make their medical preferences known. By creating an advance directive, this information is documented and provided to your care team and other people who are important to you. Individuals that do not document their preferences regarding what type and degree of care they are comfortable receiving are more likely to receive all possible treatments in medical situations where they are unable to make their wishes known. These additional or extreme measures may even go against an individual’s personal beliefs or values, but without documentation, healthcare professionals and family members must instead trust their judgment on appropriate and reasonable care.

How to get started

Start by thinking about what is important to you based on your personal beliefs, values, and preferences. If you were at end-of-life, how would you want to be treated? It’s always helpful to talk to people you trust, like family  members, friends or doctors, to help you make big decisions. This toolkit from the American Bar Association includes guided questions, worksheets and resources to help you start the process of advance planning.  It will help you think through some of the important decisions in this process, including who to appoint as your proxy, and what medical interventions you may or may not want to list as preferences. 

Once you’re ready to create the advance directive, you can search for your state’s preferred template. Print out a blank copy and follow the specific instructions for your state. Additionally, you should know that:

  • This document is a legally binding document once executed.
  • Some states require multiple witnesses to sign the forms in order to make them legally binding.
  • Some states require these forms to be notarized. If you need a notary, check with your local post office, bank, or shipping company store (e.g. UPS). You can also call 211 to ask for local directory options.

Sharing your wishes

Once the form is completed and signed, photocopy the form and give it to the person you have appointed to make decisions on your behalf; your family or friends; your health care providers; and/or faith leaders so that the form is available in the event of an emergency. Be sure the person you appoint to make decisions on your behalf fully understands your wishes. You may also want to save a copy of your form in an online personal health records application, program, or service that allows you to share your medical documents with your physicians, family, and others who you want to take an active role in your advance care planning. And remember, advance care planning decisions and wishes often change over time - you can update your advance directive as needed.

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