Writing an Advance Directive

Preparing an Advance Directive

Getting started

Do not wait for your doctor to bring up the subject of an advance directive. To help yourself develop a clear idea of your wishes, think about the kinds of medical treatments you would or would not want in different situations. See the checklist for writing an advance directive to help guide you through some of the things you may want to consider.

Involve your family, your health care agent, and your doctor in this process so they become familiar with what you want. If a situation arises that you did not anticipate, your family, health care agent, and doctor will have a better idea of how you might like to handle it.

For more information on thinking about what medical treatments you want, see:

• Should I receive artificial hydration and nutrition?
• Should I receive CPR and mechanical ventilation?
• Should I stop kidney dialysis?
• Should I stop receiving life-prolonging treatment?

Documenting your wishes

There are four important steps in preparing an advance directive:

1. Get the right forms for your state. You can get forms from:
   • A doctor's office, hospital, law office, state or local office for the aging, senior center, or nursing home.
   • A nonprofit organization called Caring Connections at www.caringinfo.org. Its Web site has free forms for every state. Or you can call the help line at 1-800-658-8898.
   • A nonprofit organization called Aging With Dignity at www.agingwithdignity.org. This organization offers a form called Five Wishes that can be used in many states. Five Wishes is easy to understand and combines a living will and power of attorney into one form. It also has you fill out things like how you want people to treat you and what you want your loved ones to know. Visit the Web site to see if you can use Five Wishes in your state or to order a form for a small fee. You can also order Five Wishes by calling 1-888-594-7437.
2. Choose someone to be your health care agent. For more information, see the topic Choosing a Health Care Agent.
3. Complete the forms and have them notarized or witnessed as your state requires. When filling out these forms, it may be helpful to organize your thoughts by using a checklist for writing an advance directive.
4. Give copies of your advance directive to your doctor, your family, and your health care agent. Keep the original document in a safe place, but do not keep it in a safe deposit box unless others have access to it. On each copy of the advance directive, write the location of the original form.

You can change your advance directive at any time by completing and distributing new forms. Do not just cross out or add new information unless it is simply a change of address or phone number. Be sure to discuss the changes that you have made with your health professional and family members.

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Author:	Jeannette Curtis	Last Updated: December 27, 2007
Medical Review:	Kathleen Romito, MD - Family Medicine Shelly R. Garone, MD - Palliative Care
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