An advance directive has information about your preferences for care in the event you become too sick to make your own decisions. It is an important document to have, because it guides your loved ones and doctors to make the best possible decisions based on your wishes.
An advance directive has two parts:
- The health care power of attorney, which names the person or people you want to make decisions on your behalf
- The living will, which contains your preferences for the medical care you receive
How to Create an Advance Directive
Penn Medicine offers a free website called Our Care Wishes that allows you to create, store and share a document containing detailed preferences about your wishes for care.
Our Care Wishes also allows Penn Medicine patients to add their advance directive directly to their Penn Medicine health record using your myPennMedicine account information. This allows your care providers to easily access it and helps your loved ones and medical providers make sure your medical care matches your goals, values and preferences.
Your Our Care Wishes document is meant to serve the purpose of an advance directive. If you want to make your document a “legal” advance directive, you will have to follow certain extra steps. The requirements vary from state to state and are subject to change. The most common requirement is that the document be signed by you and two witnesses or a notary. You can learn more about advanced directives and how to make your document legal on the Our Care Wishes website.
If you are concerned with the legal status of any document you create, you should consult with legal counsel and/or refer to your state’s specific legal requirements. You can also find copies of blank forms to make advance directives from many sources. You do not need to use a specific template.
What is Included in an Advance Directive?
An advance directive usually includes your preferences for medical care and your chosen health care decision makers. Our Care Wishes allows you to add other information about your preferences, values and what matters to you most. You may choose which parts to add to your document.
What is a Health Care Decision Maker?
A health care decision maker (sometimes called a health care agent or durable power of attorney agent) is an individual you have chosen to speak on your behalf and make decisions for you. They should be someone you trust who is at least 18 years of age or older. It is important to carefully specify this person’s role and responsibilities in your advance directive.
It is a good idea to choose at least two health care decision makers in the event that one of them is unable to make decisions for you when this document comes into effect. They can be a spouse, blood relative or a loved one. Note that you cannot name your health care provider to be your health care decision maker.
What is a Living Will?
A living will specifies how your health care decision makers will carry out your wishes, your organ donation preferences, your treatment preferences and your personal values, including what is most important to you at the end of life.
A living will may include instructions about your wishes regarding:
- Antibiotics to treat infections
- Artificial nutrition and hydration: Liquids that are given through a tube into your nose, stomach or veins if you are unable to eat or drink.
- Cardiopulmonary resuscitation (CPR): Intervention if your heart stops
- Dialysis: A method of purifying the blood as a substitute for normal kidney function
- Intubation: The placement of a thin flexible tube into the windpipe to help you breathe
- Mechanical ventilator: Machine-assisted breathing if you are unable to breathe on your own