Advance Directives: Living Wills, Health Care Proxies, and POLST

Advance directives are the documents that answer two hard questions before a crisis does: What medical care would your parent want if they could not speak for themselves? and Who should speak for them? Completing them is one of the kindest things a family can do, because it takes guesswork and guilt off the people left making decisions in a hospital hallway.

What counts as an advance directive

"Advance directive" is an umbrella term. According to Medicare, an advance directive usually has two parts:

• A health care proxy (also called a durable power of attorney for health care) that names a person to make medical decisions if your parent cannot.
• A living will that describes which treatments your parent would or would not want if their life is threatened, such as dialysis, breathing machines, resuscitation, and tube feeding. It can also record wishes about organ and tissue donation.

Many states combine both into a single form. Others keep them separate. Some people also complete a POLST form, which is different and is explained below.

The living will

A living will speaks for your parent in their own words. It typically covers situations like a terminal illness, permanent unconsciousness, or end-stage dementia, and states preferences about:

• CPR (cardiopulmonary resuscitation)
• Mechanical ventilation (a breathing machine)
• Artificial nutrition and hydration (tube feeding and IV fluids)
• Dialysis
• Comfort care and pain relief, even if it might shorten life
• Where they would prefer to be at the end of life, if possible

A living will cannot anticipate every situation. That is why the health care proxy matters so much.

The health care proxy

The health care proxy, or health care agent, is the person who talks with doctors and makes decisions when your parent cannot. The proxy is supposed to decide the way your parent would, not the way the proxy personally would.

The National Institute on Aging suggests choosing someone who:

• Is an adult your parent trusts and can talk with openly
• Will honor your parent's wishes even when they disagree
• Can handle pressure from relatives and medical teams
• Is reachable quickly, and ideally lives nearby
• Has agreed to take on the role

NIA also advises against naming your parent's own health care providers or staff at their care facility. Naming an alternate is wise in case the first choice is unavailable.

The health care proxy is a cousin of the financial power of attorney. They are usually separate documents; see our guide to power of attorney for the money side.

POLST: medical orders for serious illness

POLST is a portable medical order, not a legal planning document. It begins with a conversation between the patient and their health care team and results in a form signed with a clinician that tells emergency and hospital staff which treatments to give or withhold.

According to National POLST, POLST is intended for people who are seriously ill or have advanced frailty. It is optional. Depending on the state, it may be called MOLST, POST, MOST, or another name.

If your parent is seriously ill, a POLST conversation often comes up alongside hospice or palliative care.

Getting the right state forms

Advance directives are governed by state law, so use your parent's state form. Free options:

• CaringInfo, a program of the National Alliance for Care at Home, offers free, state-specific advance directive forms and instructions for every state, D.C., and Puerto Rico at caringinfo.org.
• Your state health department or attorney general often posts official forms.
• Hospitals and doctors' offices usually have forms, and some have staff who can help.
• Veterans who receive care at VA can complete VA Form 10-0137, the VA Advance Directive, with their VA care team.

Signing rules differ. Some states require two witnesses, some a notary, and some restrict who can be a witness (for example, relatives or people who would inherit). Read the instructions on the form. A form that is not signed correctly may not be honored.

The conversation matters more than the form

A completed form with no conversation behind it leaves the proxy guessing. Encourage your parent to talk through questions like:

• What makes life worth living for you right now?
• Are there conditions you would find unacceptable to live with?
• If you were very sick, would you want to try every treatment, or focus on comfort?
• Where would you want to be cared for near the end?
• Are there spiritual or cultural practices that should be honored?

Faith and family traditions shape these choices for many families. Clergy can be a real help here. If the topic feels too heavy to raise, our guide on talking to parents about care offers gentle openers.

Medicare covers advance care planning conversations with your parent's doctor. When it is part of the yearly Wellness visit and the provider accepts assignment, there is no cost to your parent.

Make sure the documents can be found

An advance directive locked in a safe deposit box does no good at 2 a.m. in an emergency room. After signing:

1. Give copies to the health care proxy, the alternate, and your parent's primary doctor and specialists.
2. Ask the hospital your parent uses most to scan it into their medical record.
3. Keep a copy at home in an easy-to-find spot, and note its location in your family's records.
4. Bring a copy to every hospital admission, surgery, or move into a care facility.
5. Review it after a new diagnosis, a death or divorce, or every few years.

Common misunderstandings

• "It means they won't treat Mom." No. An advance directive only guides care in the situations it describes. Your parent can choose full treatment, limited treatment, or comfort care.
• "We only need it if Dad is old or sick." Any adult can have a sudden accident or illness. It is easier to complete when everyone is calm.
• "The family can decide anyway." Many states have default rules for who decides when there is no proxy, but they may not match what your parent wants, and siblings may disagree.

When family members disagree

Disagreements are common, especially between siblings who live near and far. A clear written directive and a named proxy reduce conflict because the decision is no longer up for a family vote. If disagreement continues at the bedside, ask for the hospital's social worker, chaplain, palliative care team, or ethics committee. These are normal resources, and asking for them is not a failure.

Completing advance directives is a gift to your parent, who gets to be heard, and to the people who love them, who get to act with confidence instead of fear.

Last reviewed October 19, 2026. General information only, not medical, legal, or financial advice. Benefit rules and amounts change, so confirm with the agency before you decide. See our disclaimer.