Understanding Advance Directives: What Families Should Know
Planning for future medical care is something many people put off, yet advance directives are among the most important documents you can create to ensure your wishes are honored. These documents empower you to communicate your healthcare preferences long before a crisis—and give loved ones clarity during emotionally challenging times.
In this guide, we will walk through the key types of advance directives, how they work, who can create them, and how families should manage them.
What Are Advance Directives?
“Advance directives” is a broad term that refers primarily to two legal documents:
Healthcare Proxy (or Durable Healthcare Power of Attorney)
Living Will
Together, these documents allow you to express your healthcare wishes if you become unable to speak or make decisions for yourself.
These tools give you two essential protections:
A written record of your preferences for care in end‑of‑life or incapacitated situations
A designated decision‑maker who can speak with doctors on your behalf
1. Living Will vs. Healthcare Proxy: What’s the Difference?
Although often discussed together, these documents serve distinct purposes.
Living Will
A living will outlines what you want in specific medical situations—usually end‑of‑life scenarios such as:
Persistent vegetative state
Terminal illness
Situations where recovery is unlikely and you may lose the ability to decide
A living will states whether you want:
Life‑sustaining treatments
Feeding tubes
Ventilators
Resuscitation
Other interventions prolonged or withheld
It provides clarity for your family and medical team during incredibly difficult moments.
Healthcare Proxy / Durable Healthcare Power of Attorney
A healthcare proxy appoints an agent to make medical decisions for you when you cannot.
Your agent can speak to doctors, review options, and decide in accordance with your values and preferences. Unlike a living will, it doesn’t list treatments—it names the person who will make decisions when needed.
2. Who Can Execute Advance Directives?
In most states, any adult over age 18 who has not been declared legally incompetent by a court may execute these documents.
There is no upper age limit. You can complete advance directives at any stage of adulthood.
3. How Long Do Advance Directives Last?
Advance directives are generally valid indefinitely unless:
You include an expiration date
You revoke them
You replace them with updated documents
You pass away
Most people choose to leave them open‑ended to ensure ongoing protection.
4. Understanding MOLST and POLST Forms
In addition to traditional advance directives, many states use:
MOLST – Medical Orders for Life‑Sustaining Treatment
POLST – Physician Orders for Life‑Sustaining Treatment
These documents differ from living wills:
Key Distinctions
They are medical orders, not legal documents.
They are created with a doctor, based on your current medical condition.
They specify decisions such as:
Whether you want to be intubated
Whether you want CPR
Whether you want antibiotics or other interventions
Once completed, these orders are placed directly into your medical chart and must be followed by healthcare providers.
5. What Is a DNR?
A Do Not Resuscitate (DNR) order instructs medical professionals not to perform CPR if your heart stops.
Important details:
A DNR is also a medical order, signed by a physician.
Hospital and non‑hospital (for EMTs) versions exist.
Clients sometimes mistakenly believe they “signed a DNR,” when in reality a doctor must authorize it and place it in their chart.
6. What Should You Do After Signing Advance Directives?
Advance directives are only useful if the right people have access to them.
Who Should Receive Copies
Your primary care physician
Any specialists you see regularly
Your appointed healthcare agent(s)
Some clients hesitate to share these documents with their agents, but communication is essential. If someone may be asked to make life‑or‑death decisions for you, they must:
Know they have been appointed
Understand your values
Be willing to carry out your wishes
These conversations can be emotional, but they prevent confusion and conflict later.
Final Thoughts
Advance directives provide clarity, peace of mind, and legal empowerment during some of life’s most difficult circumstances. By completing these documents and discussing them with your healthcare providers and chosen agents, you protect your autonomy and give your loved ones the guidance they’ll need in a crisis.