5 minute read

Advanced Directive Definition

What is an advanced directive? Trust & Will shares the definition of advanced directive, as well as some common examples.

Patrick Hicks

Patrick Hicks, @PatrickHicks

Head of Legal, Trust & Will

Imagine a future in which you’re incapacitated. You’re unable to communicate your wishes, but your doctor knows exactly which procedure you’d choose. Better yet, they know this because you told them directly, and not because of outside influence. How is this even possible? This would be possible if you put your advanced directive in place today. 

It certainly isn’t fun to think about, but each and every one of us should be thinking about our future medical care sooner than later. Just as we would save up for an emergency, it can feel empowering to prepare for unfortunate circumstances that could strike, especially when it could make a difference between life or death.

Creating an advanced directive is the only surefire way of making sure our medical care wishes will be honored, and without outside influence at that. We get that this can seem abstract and confusing, but don’t worry. In this guide, we provide the advanced directive definition, plus common examples. That way, you’ll feel equipped to move forward should you decide to create one. 

What is an Advanced Directive? 

An advanced directive is a set of legal documents that dictate what should happen if you were to become physically or cognitively incapacitated. By writing down your wishes ahead of time, your loved ones and medical providers are provided with a framework to make decisions on your behalf when you are unable to make them or express them yourself. As you might imagine, this cuts out a lot of guesswork that can cause stress during an emotionally-charged and challenging time.

The term advanced directive is often used interchangeably with ‘living will,’ but they are not exactly the same. (Although the advanced directive definition is similar to that of the living will in that they share the same objective of expressing your wishes regarding your future medical care.) Rather, a living will is a type of advanced directive, along with a few others. We go over the different types of advanced directives next.

What Are the 3 Types of Advanced Directives?

Earlier, we talked about how a living will is a type of advance directive. There are two other types of advance directives that are common: a medical Power of Attorney, and a psychiatric advance directive. There are a few other documents, such as a physician orders for life-sustaining treatment (POLST) or do not resuscitate (DNR) orders that are often associated with advanced directives. However, these are not technically advanced directives because they are medical forms and not legal forms. 

For now, we’ll expand on those documents that truly are advanced directives. 

Living Will

A living will is a legal document through which you can discuss your wishes regarding your future medical care. If you are alive, but are unable to communicate your decisions, your care providers can refer to your living will document to direct their decision-making.

Medical Power of Attorney (POA)

The medical power of attorney (POA) allows you to name someone who will act as your agent to make calls regarding your healthcare. This document, and the individual you name, or also called a healthcare proxy. It comes into effect when you become incapacitated and can’t make or communicate your decisions on your own. Read about the medical POA and other types of POAs.

Psychiatric Advanced Directive

A psychiatric advance directive, or PAD, is a legal document that expresses your preferences for mental health treatment. You can also name a proxy who can make decisions on your behalf if you experience a mental health crisis and are unable to make decisions. Currently, only 25 states accommodate PADs. With the rise of mental health awareness, PADs are becoming more recognized and accepted.

What is an Example of an Advanced Directive?

Understanding the different types of advance directives is one thing, but knowing what each of these documents entail is another. A good example to use is that of a living will. Note that this is a hypothetical example of what could be included in a living will, and is not intended for actual use.

  • Statement that you have prepared guidelines regarding your medical wishes

  • When these guidelines should be followed, and who you are authorizing to follow them (actual authorization is done through the medical POA)

  • List of conditions in which guidelines should be followed, such as:

    • Unconscious state, minimally conscious state, or coma

    • Incurable or terminal illness that interferes with decision-making

    • Brain damage or disorder that affects cognitive ability 

    • Advanced dementia 

    • Any other scenario that prevents clear communication, recognition of loved ones, care for oneself, ability to swallow food or water

  • When medication or treatment should be stopped

  • Whether or not you would like life-prolonging treatments

  • If you would want a do not resuscitate (DNR)/ do not intubate (DNI) order written

  • If you accept or refuse any: antibiotics, transfusions, dialysis, invasive procedures, or surgery

  • Scenarios in which exceptions to these guidelines should be made

  • Requests for care, comfort, and hygiene

  • Explanation for whether your prefer a natural death

  • Desired location of death, if it can be arranged

  • Guidelines regarding hospice care and other institutions or facilities

  • Guidelines as to what should take place if healthcare provider does not obey wishes expressed in living will or through medical POA (legal suit; transfer institutions)

  • Whether or not you would like to donate your organs or tissues upon death

  • Any other applicable wishes regarding end-of-life care and arrangements

Once you have completed your living will, you would need to sign and date your document in front of witnesses. Most states require two signatures, who also must sign and date the document. The purpose of the witnesses is to confirm that you signed your document into effect while you were of sound mind and of your own free will. Some states may also require that you get your document notarized.

Who Needs an Advanced Directive?

Absolutely anyone over the age of 18 needs an advanced directive. This is true regardless of whether you are young, old, healthy, or in poor health. It’s also true even if you have discussed your health care wishes with your family.

This is because anyone is at risk of experiencing a circumstance in which they become medically incapacitated, at any time. 

By having an advanced directive, you can have peace of mind knowing that you already set forth your own guidelines regarding your medical care. Even if you have a living will, it’s strongly recommended that you take the extra step to make it an advanced directive by adding a medical POA. That way, you can be sure that a trusted individual will follow your guidelines and make decisions, and not a physician that you don’t know.

Finally, think about how much it could support your loved ones. If an advanced directive becomes necessary, it means that situation is dire. They are already navigating a challenging time, and adding life-or-death medical decisions could create undue grief, stress, and trauma. By having an advanced directive in place, no one has to guess. It also prevents a well-meaning loved one from making a decision that doesn’t align with your core beliefs or desires. 

Create Your Advanced Directive with Trust & Will

In review, we explained that an advanced directive is any type of legal document that describes your wishes regarding your future medical care. Advanced directives are put into use when your cognitive or physical functions are affected such that you can’t make your own decisions or communicate them. Accidents, injuries, and illnesses are all common reasons why a person could become incapacitated, and it could happen to anyone.

We also discussed that to create an advanced directive, you need to put into place both a living will and a medical power of attorney. The living will is the document you use to express your wishes, and the medical power of attorney is the document you use to name your medical agent. This is the individual you are authorizing to use your living will guidelines to make medical decisions on your behalf. Taking the extra step of creating the advanced directive is vital, because it ensures that someone you trust is making those decisions, and not a stranger.

Last but not least, creating an advanced directive can bring much peace of mind to you and your loved ones. If you were to become incapacitated, decision-making regarding your medical care can be extremely helpful. Setting forth your own guidelines will make everyone feel relieved, including you, that you are receiving medical care in line with your wishes. 

Do you feel ready to create your advanced directive? Trust & Will’s estate planning platform empowers people to establish their critical legal documents in just a matter of minutes. Find out all the health care documents you can establish today!

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