Advance Care Directives

Living Wills

A living will explains the care you do or do not want. In it, you can state your wishes about receiving:

• CPR (if your breathing stops or your heart stops beating)
• Feedings through a tube into a vein (IV) or into your stomach
• Extended care on a breathing machine
• Tests, medicines, or surgeries
• Blood transfusions

Each state has laws about living wills. You can find out about the laws in your state from your providers, the state law organization, and most hospitals.

You should also know that:

• A living will is not the same as a last will and testament after a person's death.
• You are not able to name someone to make health care decisions for you in a living will.

Other Types of Advance Directives

Other types of advance directives include:

• Special health care power of attorney is a legal document that allows you to name someone else (a health care agent or proxy) to make health care decisions for you when you cannot. It does not give power to anyone to make legal or financial decisions for you.
• A do-not-resuscitate order (DNR)is a document that tells health care providers not to do CPR if your breathing stops or your heart stops beating. Your provider talks to you, the proxy, or family about this choice. The provider writes the order on your medical chart.
• Fill out an organ donation card and carry it in your wallet. Keep a second card with your important papers. You can find out about organ donation from your provider. You can also have this choice listed on your driver's license.
• Verbal instructions are your choices about care that you tell providers or family members. Verbal wishes usually replace those you made previously in writing.

Additional Information

Write your living will or health care power of attorney according to your state's laws.

• Give copies to your family members, providers, and health care agent.
• Carry a copy with you in your wallet or the glove compartment of your car.
• Take a copy with you if you are in a hospital. Tell all medical staff involved in your care about these documents.

You can change your decisions at any time. Be sure to tell everyone involved, family members, proxies, and providers, if you make changes to your advance directive or a living will is changed. Copy, save, and share the new documents with them.

References

Fabiny A, Sabatino C. Living Wills: A Guide to Advance Directives, the Health Care Power of Attorney, and Other Key Documents. Cambridge, MA: Harvard Health Publications; 2013.

Rakel RE, Trinh TH. Care of the dying patient. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 5.

Zorowitz RA. Ethics. In: Ham RJ Jr, Sloane PD, Warshaw GA, Potter JF, Flaherty E, eds. Ham's Primary Care Geriatrics: A Case-Based Approach. 6th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 7.