Everything You Need to Know About Advanced Directives

A study published in 2013 by Medscape noted that more than 60 percent of adults in America expressed a desire for personal end-of-life wishes to be followed, but only about a third of those survey participants reported having an advance directive on file. According to other surveys, only around a fourth of individuals have living wills on file. Numerous reasons exist for this discrepancy between desire and action. Many people aren’t aware of the need for advance directives, and many more shy away from discussing the decisions required by such a document.

What Is an Advance Directive?

An advance directive is sometimes referred to as a living will. It is a legal document that lets you lay out your wishes for medical care if you are ever incapacitated, which means you are so ill or hurt that you cannot express these wishes yourself. Usually, advance directives are concerned with end-of-life care, and you might include a personal decision on whether you want to be connected to life-saving machines such as breathing machines or dialysis machines. Other directives that might be included in the document are:

  • Whether or not you want to be resuscitated if your heart stops
  • Whether you wish to be tube fed if you cannot otherwise feed yourself
  • Whether you wish to be an organ donor

While some states call these documents a living will, it is not the same form as a last will and testament, which is the document you use to specify how your assets should be treated after your death. A living will is a healthcare-oriented document and a last will and testament is a financial document. The National Hospice and Palliative Care Organization offers a downloadable brochure that provides more details about the different types of documents involved in end-of-life planning.

Who Needs an Advance Directive?

Any adult who wants to maintain control over their medical care despite their cognitive or physical ability at the time of that care should have an advance directive. Accidents and illnesses can befall individuals of any age, but if you are over 55, then you are at an increased risk of experiencing a situation caused by age-related illnesses. Advance directives don’t take a long time to complete — you can even download and complete your own form in a matter of minutes.

What Is Required for an Advance Directive Form?

In most cases, you have to be an adult of sound mind to execute an advance directive. If it can be argued that you were not mentally capable of understanding your decisions when you signed the form, or if you signed it under duress, then it can be challenged in court. Most states require that you sign the form in front of two witnesses. Those two people must also sign it, and neither individual can be the person to whom you are transferring decision-making power. Some states also require that an advance directive be notarized for it to be legally binding. To avoid your preferences being discounted because distraught family members were able to contest an advance directive, make sure you follow the specific requirements of your state.

Choosing Your Healthcare Agent

In your advance directive form, you must choose a person as your healthcare agent. This is the person who will become legally able to make decisions on your behalf should you be unable to do so. Depending on your state, this person might also be called your healthcare proxy or healthcare power of attorney. Advance directives alone do not give this person any power over other decisions, such as those related to your finances. Even so, you’ll want to carefully consider friends and family and choose someone you know will follow through on any wishes you express.

Advance Directive Forms for Different States

Advance directive forms in each state follow the same basic rules, but small details do vary. It’s important that you use the form that is legally recognized in your state. You can download an advance directive template for your specific state if you want to complete an advance directive yourself, but most experts recommend working with an estate law attorney on these forms so you don’t risk problems with minor details.

Living Wills as Part of Your Estate Plan

Living wills can be powerful documents, helping to uphold your healthcare wishes at a time when you no longer have a voice. They don’t protect all your wishes, though, which is why it’s important to understand all estate planning options. At the very least, if you haven’t already done so, you might consider creating a last will and testament with directions on how you want your assets disbursed among heirs.

Some people record their desires for burial and funeral arrangements in estate planning documents, although such documents aren’t always handled as quickly as funeral arrangements. If you have specific wishes for an end-of-life celebration, such as a preference for cremation, it’s a good idea to speak with your loved ones and providers like Neptune Society ahead of time. You can plan ahead, prepaying for service to reduce the weight of such decisions on your family.


The Neptune Society is the nation’s oldest and largest provider of affordable cremation services. Whether you have an immediate need or want to plan cremation services in advance, we are always available to assist you and your family.

Call 1-800-NEPTUNE (800-637-8863) today or contact us online to learn more.