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Health care directives allow you to inform medical professionals and family members about what kind of care you want when you can't communicate those wishes yourself. This article reviews several types of documents that help you set out your wishes in advance or name someone to speak on your behalf. The exact names for these documents can depend on the state in which you live.
This document—also known as a health care "declaration" in some states—bears no relation to the conventional will or living trust used to leave property at death, despite its name. It's a document that lets you declare what type of medical treatment you do or do not wish to receive if you are too ill or injured to manage your own care. (Among other things, you can use it to be sure doctors do—or do not—"pull the plug.") The document may have a different name in your state, but you'll recognize it as the place where you write down your specific wishes about different types of medical care.
This document, also known as a medical power of attorney or medical POA, allows you to name a trusted person to make medical decisions for you if you are unable to communicate on your own. The person you name to make these decisions is usually called your agent or attorney-in-fact.
You can give your agent the authority to oversee the wishes you've set out in your health care declaration, as well as the power to make other necessary decisions about health care matters.
Note that a POA for health care is a separate document than a POA for finances, which names a person who can act on your behalf in financial, rather than health, matters.
In addition to "agent" or "attorney-in-fact," health care representatives are sometimes also called "proxies," "patient advocates," "surrogates," or something similar. But if you hear the term "guardian" or "conservator," that probably means something different.
Guardians and conservators are court-appointed decision makers, unlike those that you appoint yourself in a health care directive. One of the best reasons to make health care directives is to avoid complicated or stressful conservatorship or guardianship proceedings. If you become incapacitated and don't have a health care directive that names someone to make health care decisions on your behalf, your loved ones will need to initiate these court proceedings. For more information, see Conservatorships and Adult Guardianships.
Some states combine the living will (or declaration) and durable POA for health care into a single form, most often called an "advance health care directive" or "advance directive." In these states, this single document both lays out your wishes and preferences for medical treatment (like a living will) and names a health care agent (like a power of attorney for health care).
To find out if your state combines these documents into one, see the chart in What Health Care Directives Are Called in Your State.
If a medical emergency occurs, a DNR order alerts emergency personnel that you do not wish to receive cardiopulmonary resuscitation (CPR). DNR orders are sometimes made to supplement other health care directives, usually by those who are already critically ill and feel strongly that they do not want to receive life-prolonging treatment when close to death.
If you are in the hospital, you can ask your doctor to add a DNR order to your medical record. If you are not hospitalized, you can make what's called a prehospital DNR order to keep nearby in case paramedics are called to your home or care facility.
Learn more about DNR Orders.
In almost all states, you have yet another option for setting out your wishes—a Physicians Orders for Life Sustaining Treatment (POLST) form (also called a POST, MOLST, or MOST form, among other terms). POLST forms allow you to express your wishes for care in a medical emergency. In this way, they are similar to DNR orders. However, a POLST form covers more medical decisions than a DNR order. For example, you can use a POLST form to state your wishes about intubation, antibiotic use, and feeding tubes.
The documents used to state your wishes for health care go by many names. Here's a chart to help you sort through the terminology.
| Term | Also Called | What It Means |
|---|---|---|
| Living Will | Directive to Physicians, Health Care Declaration, Medical Directive, Health Care Directive | A legal document in which you state your wishes about life support and other kinds of medical treatments. The document takes effect if you can't communicate your own health care wishes. |
| Durable Power of Attorney for Health Care | Medical Power of Attorney, Power of Attorney for Health Care, Designation of Surrogate, Patient Advocate Designation | A legal document in which you give another person permission to make medical decisions for you if you are unable to make those decisions yourself. |
| Advance Health Care Directive | Any of the documents discussed above may be called an advance health care directive; the term most often refers to a legal document that includes both a health care declaration and a durable power of attorney for health care. This type of combined form is currently used in more than one-third of the states. | |
| Do-Not-Resuscitate (DNR) Order | DNR Form, DNR Directive, Comfort One | A medical order or form, usually signed by a doctor, that documents your wish not to receive CPR or other invasive resuscitation techniques if you stop breathing or your heart stops beating. |
| Physician Order for Life-Sustaining Treatment (POLST) Form | Provider Order for Life-Sustaining Treatment, Physician orders for Scope of Treatment (POST), Medical Orders for Scope of Treatment (MOST), Medical Orders for Life-Sustaining Treatment (MOLST), Clinician Orders for Life-Sustaining Treatment (COLST), Transportable Physician Orders for Patient Preferences (TPOPP) | A medical order signed by a doctor or other qualified health care professional. A POLST form is used in health care settings to document your instructions for medical care at the end of life. It is not a substitute for an advance health care directive. |
| Attorney-in-Fact for Finances | Agent for Finances | The person you name in your durable power of attorney for finances to make financial decisions for you if you cannot make them yourself. |
Living wills, health care powers of attorney, and advance directives go by different names in different states. Below, you'll find a chart that describes how your state refers to these documents.
State
Number of Documents
Living Will
Durable Power of Attorney for Health Care
Advance Directive for Health Care
Advance Health Care Directive
Health Care Power of Attorney
Durable Power of Attorney for Health Care
Advance Health Care Directive
Declaration as to Medical or Surgical Treatment
Medical Durable Power of Attorney
Document Concerning Health Care and Withholding or Withdrawal of Life Support Systems
Appointment of Health Care Representative
If you name a health care agent and leave health care instructions, your wishes will be combined into a single form called Health Care Instructions and Appointment of Health Care Representative.
Advance Health Care Directive
District of Columbia
Durable Power of Attorney for Health Care
Designation of Health Care Surrogate
Advance Directive for Health Care
Advance Health Care Directive
Living Will and Durable Power of Attorney for Health Care
Durable Power of Attorney for Health Care
If you name a health care agent and leave health care instructions, your wishes will be combined into a single Durable Power of Attorney for Health Care form.
Living Will Declaration
Durable Power of Attorney for Health Care and Appointment of Health Care Representative
Durable Power of Attorney for Health Care
Durable Power of Attorney for Health Care Decisions