How to Create an Advance Directive: Dos and Don’ts

It’s easy to pretend that nothing will ever happen to you or a family member, but failing to prepare for the potential can cause more complications should the worst happen. That’s why having an advance directive is important, regardless of your age or health status. 

What Is an Advance Directive?

An advance directive is a legal document that provides guidance on what kind medical care you want. In the event that you aren’t able to make decisions for yourself, an advance directive instructs your loved ones and medical staff what you want. 

Advance directives aren’t just for the elderly or terminally ill; it’s impossible to predict when a health issue or accident could impact someone’s ability to make decisions. Thinking ahead ensures you get the kind of care you want and relieves pressure on (and sometimes tension between) loved ones who would otherwise be trying to guess about the choices you’d make.

There are two primary types of advance directives:

• A Living Will is a written record of your preferences for medical treatments and decisions, including pain treatment and organ donation, as well as under what conditions you’d like to receive life-sustaining care.
• A Medical Power of Attorney is when you name someone to make medical decisions on your behalf, should you be unable to do so yourself. Even if you have a living will, having a medical power of attorney is important.

Creating an Advance Directive

Creating an advance directive begins with reflecting on your values and wishes: what do you want? You may want to consult your healthcare providers to get an idea of what kinds of decisions may be likely to come up. For example, those with high blood pressure may want to think deeply about what they’d want in the event of a stroke.

When you’re ready to take action, here are some do’s and don’ts to keep in mind. 

Don’t: Wait Until You’re Ill

You never know when something could happen to you, such as an injury or sudden illness. If you wait until you need an advance directive, it may be too late. You must be of sound mind and able to voluntarily sign the document when putting your advance directive into place. 

Do: Use a Valid Advance Directive Form

Individual states have their own advance directive forms. You can find them online, and many organizations, such as AARP, provide forms across all states. Many states recognize out-of-state advance directive forms, but if you regularly go between states, such as if you have homes in multiple states, you may want to compare forms to ensure that you provide all the information needed on both forms or consult with your lawyer. 

Don’t: Choose the Wrong Signature Witness

An advance directive must be signed in front of two witnesses to be valid. To avoid any conflicts of interest, there are guidelines around who these witnesses can be. It’s important to make sure your witnesses meet these guidelines or your advance directive could be invalidated. Witnesses must be:

• 18 years of age or older
• Someone who is not a member of your medical care team
• Someone who is not related to you
• Someone who has no claim on your estate

Do: Carefully Consider Who You Name as Your Agent

Your medical power of attorney, also commonly referred to as a health care agent or health care proxy, plays an important role in ensuring your wishes will be carried out. It is impossible to predict and dictate your wishes for every potential situation in your living will. A medical power of attorney can use your living will, as well as your values, as the foundation to make additional medical care decisions.

A good person to name as your agent is someone who you trust, who understands your values and who is able to effectively communicate your wishes. They need to be willing to take your written wishes and apply those values to other situations and advocate on your behalf. You may also want to choose someone who lives nearby so they can be accessible should you need them.

It’s important to have conversations with your chosen medical power of attorney to ensure that they are willing to take on the responsibility. They should understand what you’re asking of them and have the opportunity to review your advance directive and ask questions so they have a clear understanding of your wishes. 

Don’t: Choose More than One Agent

To ensure medical decisions can be made in a timely manner and without conflict, it’s best to choose one medical power of attorney. Logistical problems may arise if there are disagreements, and institutions may not have clarity about who truly speaks for you. You can, however, name a principal medical power of attorney and an alternate who can step forward if the primary agent is unable or unwilling to act as your medical power of attorney. 

Do: Document Your Medical Wishes

Once you’ve created your advance directive, share it with your loved ones and medical team. You may not have control over who is with you or what medical facility you are taken to should something arise, so providing guidance to as many people as possible helps ensure that your treatment preferences and decisions about end-of-life care are respected.  

Don’t: Forget to Update Your Advance Directive

When your life circumstances change, it’s important to review your advance directive and make updates as needed. For example, a relationship change – such as marriage, divorce or widowhood – may prompt a change your medical power of attorney. A new diagnosis could impact the wishes you’ve outlined in your living will. Add a regular review of your advance directives to your to-do list, just as you should regularly review your will and life insurance beneficiaries. 

Do: Work with a Professional

While you understand your values and wishes, you may not always know the best way to communicate them to healthcare professionals. This is where working with a legal professional could help. Ask about their past experience; while you are new to the process of creating an advance directive, their knowledge can help keep things running smoothly and alleviate stress. 

An advance directive is just one aspect of planning for your future. Remember, an agent appointed under an advance directive does not have the power to make decisions regarding your financial affairs. That is a separate document- typically referred to as a durable financial power of attorney. Connect with a Farm Bureau agent or financial advisor to discuss other topics, such as leaving a legacy and creating an estate plan.