Putting Priorities on Paper: Your Advance Directive

Your Advance Directive (AD) is the cornerstone of your advance planning. It makes your end-of-life preferences clear if you are unable to make or communicate medical treatment decisions yourself. Typically an advance directive includes a living will (“what I want”) and a medical durable power of attorney (“who will speak for me”). It can also include other documents to spell out your wishes.

Your living will specifies what kinds of treatment and care you would or would not want in order to sustain life. Your durable power of attorney authorizes someone you trust to act as your representative and make medical decisions for you if you cannot make them for yourself. These are healthcare documents and do not include financial, estate or business concerns. Advance directives are only useful if they are completed before a health crisis and are available when you are unable to speak for yourself.

Medicare Beneficiaries, Please Take Note! Medicare now reimburses doctors for 30-minute sessions of advance care planning with patients. This service includes conversations before an illness progresses and during the course of treatment. If you are a Medicare beneficiary, you can ask your doctor about adding advance care planning to your annual wellness visit or routine office visit. For more information, see Medicare Coverage of Advance Care Planning, available at Coalitionccc.org.

Completing Your State-Specific Advance Directive

Many states have their own forms with specific guidelines that must be used. They can be found online through your state’s website or through our Advance Directives page.

Communicating Your Advance Directive

Your advance directive can be helpful to your physician and others close to you when they must make choices on your behalf. However, the documents alone do not guarantee enforcement. That’s why it’s important to appoint someone who understands and supports your values as your healthcare representative or agent, and take the time to communicate your wishes to that person as fully and clearly as possible. It is also a good idea to bring an up-to-date advance directive to your doctor to discuss your healthcare wishes, and have the document scanned into your medical records.

Adding Other Documents

Throughout this guide you will find references to other resources that that can be added to or accompany your advance directive. You can find documents and links in the My End of Life Decisions Guide Toolkit (starting on page 15) and in our Plan Your Care Resource Center. Some specific medical orders may need to be written by a physician. The more information you can provide to prevent conflicting interpretations of your preferences, the greater the likelihood those preferences will be followed.

Storing and Reviewing Your Advance Directive

To be useful, your advance directive needs to be easily accessible and up to date. Give a copy to your designated healthcare representative, keep another in an obvious place at home so your representative or loved ones can find it, and bring one to your doctor to keep in your medical record. Review your documents regularly.

Tips for Keeping Your Advance Directive Current

  • Check to make sure your designated representative is still who you would want to speak for you and that their circumstances haven’t changed.
  • If you update your advance directive (you can, at any time), discard the document you no longer want and replace it with a revised version. Share the revised version and ask others to discard the one you no longer want.
  • Consider keeping a copy with you when you travel or know you will be away from home for a long period of time.

NEXT: Decisions About Life-Sustaining Measures

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