An advance care directive is a legal document that states your medical treatment preferences and names a healthcare proxy to decide for you if you become unable to communicate. It typically includes some combination of a living will, a healthcare power of attorney, and instructions like a POLST or DNR order, depending on your state and situation.
Estate planning is not only about what happens to your property after you die. It also covers decisions about your medical care while you are still alive but unable to speak for yourself. According to the National Institute on Aging, advance care planning starts with conversations about your preferences and ends with legal documents that memorialize them, so your family and medical team are not left guessing during a crisis.
What an Advance Care Directive Actually Is
An advance directive, per Cornell Law School's Legal Information Institute, is a legal document, or set of documents, stating your medical treatment wishes for situations where you cannot communicate them yourself. It typically covers your preferences for life-sustaining treatment and names a healthcare proxy authorized to make decisions on your behalf when you cannot. Having one in place means your loved ones are not forced to guess, or argue, about what you would have wanted.
The Documents That Make Up an Advance Directive
Durable Power of Attorney for Healthcare
This document names your healthcare agent, the person authorized to make medical decisions if you are incapacitated. It is different from an ordinary power of attorney, which typically covers financial or legal matters and often expires upon incapacity rather than continuing through it. Learn more in our full breakdown of powers of attorney.
Living Will
A living will states the specific medical treatments you want, or do not want, if you are near the end of life, covering things like life support, feeding tubes, and resuscitation. It can be a standalone document or built into your durable power of attorney for healthcare.
Physician Orders for Life-Sustaining Treatment (POLST)
A POLST is a medical order, not just a personal statement of preference, covering specific decisions like CPR, breathing machines, and hospital transfer. It must be signed by a member of your medical team to be valid, which distinguishes it from the other documents on this list that you sign yourself.
Do Not Resuscitate (DNR) Orders
A DNR order tells medical providers not to perform CPR if your heart stops or you stop breathing. Like a POLST, it typically must be signed by a physician and included in your medical chart to be recognized in an emergency, so simply writing your preference down elsewhere is not enough on its own.
HIPAA Authorization Matters Too
Healthcare providers are legally restricted from sharing your protected health information, even with close family, without proper authorization under the Health Insurance Portability and Accountability Act. Make sure your healthcare power of attorney includes HIPAA authorization language so your named agent can actually access the information they need to make informed decisions on your behalf.
Why This Matters More Than Most People Assume
Serious illness and incapacity are not limited to older adults. A car accident, a sudden cardiac event, or a severe illness can happen at any age, and without an advance directive, your family may need to petition a court for guardianship just to make basic medical decisions on your behalf. That process is public, slow, and stressful, exactly when your family can least afford it to be.
Common Questions People Get Wrong
Many people confuse a general power of attorney with a durable one. A general POA typically ends the moment you become incapacitated, the opposite of when you actually need it most. A durable POA is drafted with specific language ensuring it remains in effect through incapacity, which is the version almost everyone actually needs for healthcare and financial planning purposes. If you have not thought through the specific values questions behind these documents yet, our guide to the Five Wishes questions is a useful starting point before you draft the legal language.
How FastWill Builds Your Advance Directive
FastWill's online estate plan builder generates an advance directive matched to your state's specific requirements, including the proper HIPAA authorization language and healthcare agent designations, alongside the rest of your will and power of attorney. To avoid the most common pitfalls people run into, see our article on advance directive mistakes.
Frequently Asked Questions
What is the difference between a living will and a healthcare power of attorney?
A living will states your specific treatment preferences directly. A healthcare power of attorney names a person to make decisions on your behalf, including in situations your living will did not anticipate.
Do I need a POLST if I already have an advance directive?
A POLST is generally for people with a serious illness or advanced age who want their specific treatment preferences turned into an actual medical order their care team must follow immediately, in addition to a broader advance directive.
Can any adult create an advance care directive?
Yes, as long as you are of legal age and sound mind in your state. It is not limited to older adults or people with a diagnosed illness.
Who should I name as my healthcare proxy?
Someone you trust to follow your actual wishes, who is willing to serve, and who is likely to be reachable and capable of acting quickly if needed.
Does my advance directive expire?
Not typically, but you should review and update it periodically, especially after a major health change, a move to a new state, or the loss of a named proxy.
Do not leave your medical decisions to chance. Create your advance care directive with FastWill and make sure your wishes are on record.
