Deciding what care you would want at the end of life is only half the job. The other half is making sure those wishes are written down in the right form, shared with the right people, and legally valid, so they are actually honored when you cannot speak for yourself. That is what advance-care documents do.
The two jobs an advance directive does
“Advance directive” is an umbrella term for documents that speak for you when you cannot. Most people need two things:
A living will, which states your wishes, for example, whether you want a ventilator, feeding tube, or CPR if you are terminally ill or permanently unconscious.
A health-care proxy (also called a health-care power of attorney or durable power of attorney for health care), which names the person you trust to make medical decisions for you when you cannot.
The proxy is often the more powerful of the two, because no document can anticipate every situation, and a trusted agent can respond to what actually happens.
How a POLST is different
A POLST (Physician Orders for Life-Sustaining Treatment; called MOLST or similar in some states) is not the same as a living will. A living will is a legal document about future, hypothetical situations. A POLST is an actual medical order, signed by a clinician, for someone who is already seriously ill. Because it is a medical order, emergency responders will follow it in the moment, which a living will alone may not accomplish. POLST is meant for people with serious illness or frailty, not healthy adults.
DNR orders
A DNR (do not resuscitate) order is a specific medical order not to perform CPR. It can stand alone or be part of a POLST. If avoiding resuscitation matters to you, a spoken wish is not enough; you need the order in place and visible to responders.
Making them legally valid, and actually used
Follow your state’s signing rules. Requirements vary; some states require witnesses, some a notary, some either. An improperly executed form may be ignored.
Choose the right agent and name a backup. Talk to them about what you want.
Share copies. Give them to your proxy, your doctors, and your hospital, and keep one accessible at home. A document no one can find does nothing.
Add a HIPAA authorization so your agent can access your medical information.
Update after major changes — a new diagnosis, divorce, or death of your named agent.
Free tools to get started
You can begin your own documents with our free, private tools: a living will and health-care proxy worksheet and a power of attorney form. They are self-help templates, not legal advice, and nothing you enter leaves your browser. For complex situations or blended families, have an attorney review them.
This is general information, not legal or medical advice. Advance-directive rules vary by state, so confirm your state’s requirements.
Free tools to plan ahead
Start your own documents with our free, private tools — nothing you enter leaves your browser:
What is the difference between a living will and a health-care proxy?
A living will states your wishes about treatments like ventilators and feeding tubes. A health-care proxy names the person who will make medical decisions for you when you cannot. Most people should have both.
What is a POLST and how is it different from a living will?
A POLST is an actual medical order signed by a clinician for someone already seriously ill, so emergency responders follow it immediately. A living will is a legal document about future hypothetical situations and may not be acted on in an emergency the same way.
Do advance directives need to be notarized?
It depends on your state. Some require witnesses, some a notary, and some accept either. Following your state’s exact signing rules is essential, because an improperly executed directive may be disregarded.
How do I make sure my directive is actually followed?
Execute it correctly for your state, name a trusted agent and backup, share copies with your proxy, doctors, and hospital, add a HIPAA authorization, and update it after major life changes.
This article is general legal information, not legal advice, and may not reflect the most current law or the law in your jurisdiction. Laws vary by state and change over time. For advice about your specific situation, consult a licensed attorney.
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