What Is An Advance Directive?

All adults can benefit from thinking about what their healthcare choices would be if they are unable to speak for themselves. These decisions can be written down in an advance directive so that others know what they are.

Advance directives come in two main forms:

A "healthcare power of attorney" (or "proxy" or "agent" or "surrogate") documents the person you select to be your voice for your healthcare decisions if you cannot speak for yourself. You may authorize another person, such as a spouse, child, or friend, to be your “agent”. Thus, in the event that you become incapable of making informed healthcare decisions for yourself this person will step in and make the decision on your behalf. You can also specifically tell your agent what kinds of care you do and do not want. This authorization is, in legal terms binding that person to carry out your explicit directives without legal confrontation from other parties.
A "living will" documents what kinds of medical treatments you would or would not want at the end of life. Many people would opt to complete both types of advance directives and therefore ensure that their healthcare decisions are solidified legally.

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Where do I get an ‘Advance Directive’ form?

These forms are widely available on the internet:

AARP: End-of-life-planning

Advance Care Planning Day Initiative: Advance Care Planning

Advance care planning is a process, not just a document. Follow these five steps to make your plan:

Think about what's right for you. What are my values, beliefs and understanding about end of life care and specific medical procedures?

Learn! There are many medical procedures that can be offered at the end of life. Some may improve your quality of life, others may only prolong life. Different people have different thoughts about these procedures.

Choose your Substitute Decision Maker. Choose someone who would honor and follow your wishes, and is able to speak for you if you can't speak for yourself.

Talk about your wishes with your Substitute Decision Maker, family members and friends who are important to you. Tell your health care team. If you have a written plan, make sure they have a copy.

Record - It's a good idea to write down your wishes, or make a recording or video about your wishes for end of life care. Find out what forms are available in the state of Virginia.

Review your plan regularly, especially when something in your life changes.

Continue the conversation!

Frequently Asked Questions

When does this planning come into effect?

Your substitute decision maker is only called upon if you are unable to make your own health care decisions (e.g. you are in a coma or your illness has impaired your ability to make decisions). Also, any written documents/plans are only referred to under these circumstances. If you have a written document, your substitute decision maker can use it to guide your care and advocate for your wishes.

Can my plans change?

You can change your plans as often as you like. Just make sure that the person representing you understands your wishes and has a copy of your most recent written document.

Doesn't my doctor have the final say about my care?

Your doctor can provide valuable advice to you and your family about treatment, but needs to know about your beliefs, concerns and wishes to provide you with the care you want to receive at the end of life. Everyone has the right to make decisions about their own health care.

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