By Cassidy Smith, Written Communications Specialist

“They make it very clear to us what’s going to happen next…You can’t take care of these things too soon. People can become disabled and in a coma at 24. You’ve got to study this, got to sign the papers, got to let people know what you want, and do it soon. Then, the burden is taken off the family.”

– Linda Barrett, The Last Chapter: End of Life Decisions, West Virginia Public Broadcasting

Planning for end-of-life situations can never come early enough. Nobody can predict the future, so nobody knows when and if a life-limiting situation could happen to us. Nobody knows when something could happen to us that takes away our ability to speak, write, or even think. If something happened to you, would your family know how you would want to proceed?

In high-stress medical situations, the last thing that a family needs is the stress that comes with making life-altering medical decisions for loved ones. It can leave them wondering if they chose the path that their loved ones would have chosen for themselves. This can lead to feelings of guilt, remorse, and second-guessing.

This is why planning ahead is such a crucial action for all of us. It takes the guesswork out of our treatment and major decisions. The first big step in end-of-life planning is to write an advance directive.

What is an advance directive?

An advance directive is a roadmap for your family, friends, and medical staff to follow regarding the handling of specific situations in life-limiting situations. Usually, an advance directive comes with the appointment of a health care power of attorney (POA).

What is a health care POA?

A health care power of attorney is a person chosen to represent you in the case that you cannot make your medical wishes known. This person should understand and be trusted to follow your medical wishes. The person you choose as your health care POA should be someone close to you, like a relative or close friend, who will fight for your wishes in difficult medical situations, when the difficult decisions must be made. Depending on where you live, a health care POA may be called a:

  • Health care agent
  • Health care proxy
  • Health care surrogate
  • Health care representative
  • Health care attorney-in-fact


  • Patient advocate.

How do I write an advance directive?

There are many different form templates found on the Internet that may be used as templates for your advance directive. Find a template for your specific home state here.

What kind of information should I include in my advance directive?

  • The name of your health care POA
  • Your hopes, goals, values, and medical preferences
  • Specifics about the medical treatment you want and do not want
  • Where you would prefer to receive treatment
  • Instructions on resuscitation measures, life support, and dialysis
  • Instructions for organ, tissue, and eye donation
  • Funeral arrangements


  • Any other specific information about things you would and would not want.


When should I start thinking about writing my advance directive?

“There’s no specific event or deadline that marks when you should do one,” said attorney Norma Wells, who works closely with Shepherd’s Cove Hospice. “That said, really everybody over the age of 19 could need one at some time and could benefit from having one. They’re especially helpful if you have specific wishes regarding life support. That way, your loved ones aren’t on the spot having to make decisions for you in that state; they would only be carrying out your wishes.”


After I write my advance directive, what do I do?

You must get your advance directive notarized before it can be submitted as a legal document. Once it has been notarized, you should send a copy to your doctor, your POA, and members of your family. You may fill out a separate Provider Orders for Life-Sustaining Treatment (POLST) Form, which simply gives more detailed instructions for measures that would sustain life. Ensure that the form you use is recognized as a legal document in your state.