Planning Ahead: The Importance of Advance Directives

What would happen if you were suddenly unable to speak for yourself during a medical emergency? Who would make decisions on your behalf, and would they know what you really want?

That’s where advance directives come in.

Creating an advance directive is one of the most empowering steps you can take to protect your autonomy, reduce the burden on loved ones, and ensure your healthcare aligns with your values. This guide explains why advance directives matter, the different types available, and how to create one for yourself or a loved one.

What Is an Advance Directive?

An advance directive is a legal document that lets you outline your preferences for medical care if you’re ever unable to communicate or make decisions due to illness, injury, or unconsciousness. These documents give your loved ones and healthcare team clear instructions, so they aren’t left guessing during a crisis.

Unlike a general will or estate plan, advance directives focus specifically on healthcare choices, such as whether you’d want life-sustaining treatment, resuscitation, or artificial feeding.

Types of Advance Directives and What They Do

Understanding the types of advance directives helps you choose the right combination for your situation. Most people benefit from having at least two of the following in place.

1. Living Will

A living will allows you to document your preferences regarding life-sustaining treatments, such as:

• CPR (cardiopulmonary resuscitation)
• Ventilator use
• Tube feeding
• Dialysis
• Pain management

This document becomes active only when you’re unable to communicate and are in a critical or terminal condition.

2. Durable Power of Attorney for Healthcare

Also known as a healthcare proxy, this document names someone you trust to make medical decisions for you. This person can speak with doctors, approve treatments, or decline care based on your expressed wishes.

Choosing a durable power of attorney for healthcare is one of the most important steps in planning for the unexpected.

3. Do Not Resuscitate (DNR) Order

A DNR order is a medical directive that tells healthcare providers not to perform CPR if your heart stops or you stop breathing. It is typically used by individuals with terminal illnesses or serious health conditions.

4. POLST or MOLST Forms

Physician Orders for Life-Sustaining Treatment (POLST) or Medical Orders for Life-Sustaining Treatment (MOLST) are specific instructions for emergency personnel. These are often used for people with serious illnesses and are designed to travel with the patient across care settings.

Why Advance Directives Are Important

Many people mistakenly believe advance directives are only for the elderly or those with serious diagnoses. In reality, advance care planning is essential for adults of all ages.

Here’s why:

They Prevent Family Conflict

Without clear instructions, family members may disagree on what kind of care you should receive. An advance directive avoids confusion and painful decision-making during already stressful situations.

They Ensure Your Wishes Are Respected

Do you want all possible life-saving measures? Do you prefer comfort care only? Your advance directive ensures your values and preferences guide your care, even when you can’t speak for yourself.

They Reduce the Burden on Loved Ones

Making medical decisions for someone else, especially in a crisis, is emotionally exhausting. Having your wishes written down offers peace of mind to the people who care about you.

When Should You Create an Advance Directive?

The best time to complete an advance directive is now, while you’re healthy and fully capable of making informed decisions. Don’t wait until you’re in the hospital or facing surgery.

Advance directives are especially important if you:

• Are over age 18
• Live alone or have no nearby family
• Have a chronic illness or disability
• Have strong beliefs about end-of-life care
• Travel frequently or engage in high-risk activities

Update your documents anytime there is a major life change, such as:

• Marriage or divorce
• New medical diagnosis
• Moving to another state
• Change in your healthcare proxy

How to Create an Advance Directive

Creating an advance directive is easier than you might think. Here’s how to get started:

1. Reflect on Your Values

What quality of life is acceptable to you? Are there treatments you would never want? Consider your personal, religious, and cultural beliefs.

2. Choose a Healthcare Proxy

Select a person you trust to speak on your behalf. Make sure they’re willing to take on the responsibility and clearly understand your wishes.

3. Complete Your State’s Forms

Each state has its own requirements. Forms are usually available from:

• Your local hospital
• State health department websites
• Legal aid organizations
• CaringInfo.org (provides free state-specific forms)

4. Share the Documents

Give copies to your healthcare proxy, family members, and your doctor. Store the originals in an accessible location—not a locked safe.

5. Review and Update Regularly

Revisit your choices every couple of years or after major life events.

How to Talk to Family About Advance Directives

Many people avoid the conversation because it feels awkward or morbid. But starting early—before a medical emergency—makes it easier.

Tips for bringing it up:

• “I was reading about advance directives, and it made me think. I’d like to talk about what I’d want if I couldn’t speak for myself.”
• “This isn’t about being sick—it’s about being prepared. I want you to know my wishes so you don’t have to guess.”
• “Have you thought about what kind of care you would want in an emergency?”

Encourage your loved ones to complete their own advance directives too. It’s a gift of clarity for everyone involved.

Addressing Common Myths

Let’s bust a few myths that often stop people from taking action:

• Myth: “I’m too young to need this.”
  Fact: Tragedy or illness can strike at any age. Adults 18+ should consider an advance directive.
• Myth: “My family knows what I want.”
  Fact: Even close family members may disagree or forget in the heat of the moment. Written instructions remove doubt.
• Myth: “I’ll just deal with it later.”
  Fact: Medical emergencies don’t wait. Having a plan now avoids future stress.

Final Thoughts: Empowerment Through Planning

Creating an advance directive isn’t about being negative—it’s about being prepared. It’s a practical, powerful way to protect your voice, ease your family’s burden, and ensure that your medical care truly reflects your values.

If you’ve been putting it off, make today the day you take the first step. Your future self and your family will thank you.