The hardest decisions in a family's life often arrive when no one is ready, in a hospital hallway, with a doctor asking what your loved one would have wanted and no one quite sure. Advance directives exist to answer that question before it's ever asked. They are the documents that record a person's health care wishes and name who can speak for them, and putting them in place is one of the most loving things a family can do while there is still time and calm to do it.

This guide explains the two core documents, the medical orders that go further, how they differ from a financial power of attorney, and how to set them up.

Why This Matters Before a Crisis

Advance care planning, as the National Institute on Aging describes it, means deciding in advance the health care you would want if a serious illness or injury left you unable to speak for yourself, and putting those wishes in writing. The point is not paperwork. It is that these documents spare family members from having to guess, and from the conflict that so often erupts between loved ones who each believe they know best, during the worst week of their lives.

If you are caring for an aging parent or spouse, helping them complete these documents while they can still express their wishes is a gift to everyone who will one day have to act on them.

The Two Core Documents

There are two foundational advance directives for health care, and most people need both.

  • A living will. This is a written document stating which medical treatments a person would or would not want to sustain life if they cannot make decisions, for example CPR, a breathing machine, tube or IV feeding, dialysis, or blood transfusions. It speaks for the person when they cannot speak for themselves.
  • A durable power of attorney for health care. Also called a health care proxy, agent, or surrogate, this names a trusted person to make medical decisions on the person's behalf when they are unable to communicate them. A living will cannot anticipate every situation; a named proxy can apply the person's values to whatever actually comes up.

Together they cover both the "what" (the living will's instructions) and the "who" (the proxy who can decide in real time).

Medical Orders for Serious Illness

For someone who is seriously ill or near the end of life, there are additional documents that go a step further than advance directives, because they are medical orders signed by a clinician that providers can act on immediately.

  • A do-not-resuscitate (DNR) order tells providers not to perform CPR if breathing or the heartbeat stops.
  • A do-not-intubate (DNI) order says the person does not want to be placed on a ventilator.
  • A POLST or MOLST form (Portable, or Physician/Medical, Orders for Life-Sustaining Treatment) translates a seriously ill person's wishes into a medical order a clinician signs, so emergency staff can honor it right away.

These medical orders are distinct from advance directives, and they're generally meant for people who are already seriously ill rather than for healthy adults planning ahead.

A Health Care POA Is Not a Financial POA

One common point of confusion: a durable power of attorney for health care is different from a financial power of attorney. The health care version covers medical decisions; the financial version covers money and property. Many families need both, but they are separate documents, and naming someone to make medical decisions does not give them authority over finances, or the reverse.

Not sure which documents your family needs, or where to find your state's forms? Ask Brevy and we'll point you in the right direction.

How to Set Them Up

A few things worth knowing before you start:

  • They are state-specific. Each state has its own advance-directive forms and its own witnessing or notary rules, so use your own state's official forms, often available free from the state health department or aging agency.
  • You usually don't need a lawyer. Most state advance-directive forms can be completed without an attorney, though legal advice helps in more complex situations.
  • They take effect only when needed. Advance directives generally apply only when the person is unable to make their own health care decisions, and they can be changed or canceled at any time.
  • Distribute copies. After completing the documents, give copies to the health care proxy, the person's doctors and other providers, and close family, so the right people have them when it matters.

The conversation is often harder than the paperwork. Approach it gently, more than once if needed, framed around making sure the person's own wishes are the ones that get followed.

Free Resources Worth Saving

  • National Institute on Aging, Advance Care Planning, nia.nih.gov, clear, clinically vetted guidance on directives and proxies
  • Eldercare Locator, 1-800-677-1116, connects you to your local Area Agency on Aging, which can point you to your state's forms
  • MedlinePlus, medlineplus.gov, plain-language health information from the National Library of Medicine

FAQ

A living will is a written document stating which life-sustaining treatments a person would or would not want if they cannot decide for themselves. A durable power of attorney for health care names a trusted person to make medical decisions on their behalf when they cannot. The living will is the instructions; the proxy is the person who applies them to real situations. Most people benefit from having both.

Usually not. Most states provide advance-directive forms that you can complete without an attorney, often for free through the state health department or aging agency. Legal advice can help in more complex situations, and because the forms and witnessing rules are state-specific, use your own state's official forms.

Yes. Advance directives generally take effect only when the person is unable to make their own health care decisions, and they can be changed or canceled at any time. If they change, tell the proxy, family, and providers, and replace the old copies.

No. A POLST or MOLST form translates a seriously ill person's wishes into a medical order that a clinician signs, so emergency staff can act on it immediately. It is a medical order, distinct from an advance directive, and it is generally meant for people who are already seriously ill rather than for healthy adults planning ahead.

Learn More

Planning ahead is one of the kindest things a family can do, and you don't have to navigate it alone. If you want help understanding what documents and decisions fit your family's situation, start with Brevy. We'll stay with you for as long as it takes.

Find personalized help with caregiving and care planning at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

BC

Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.