Which Healthcare Directives Do You Need?

Which Healthcare Directives Do You Need?

“Out of control. Everything felt so out of control. The doctors were recommending surgery. We weren’t sure if Mom would survive, and if she did, we worried she would be left with a poor quality of life. We didn’t know her wishes. My brother and I were at odds over the decision. And, since she passed away, we’ve hardly spoken.”

As a professional speaker teaching on the topic of healthcare directives, I hear lots of stories. After every presentation, folks from the audience come up and share their experiences. Some make me smile, like stories about an elderly father’s peaceful passing, with his adult children and wife loving and supporting him and one another, confidently knowing his end-of-life care wishes were honored. Unfortunately, most stories reveal the chaos, confusion and conflict that occurs when families are left to blindly wrestle with life and death decisions for a loved one in the absence of a healthcare directive.

If you’ve heard me speak or have been following my blog, perhaps you are ready to begin writing your directive. You might be wondering where to start. As a reminder, a healthcare directive typically has two parts: healthcare instructions and a healthcare power of attorney.

Healthcare Directives Components


Which directive documents do you need to complete?

Optimally, you are willing and able to describe your healthcare preferences in writing to be certain your wishes are clear, and you have at least one person you can trust to serve as your healthcare agent.

However, not everyone has the optimal situation. For some, there really is no one trustworthy enough to serve as a healthcare agent. Others may be physically, mentally, or emotionally unwilling or unable to write down their preferences.

The three scenarios presented below demonstrate that in some cases, only one of the two parts is completed. Assess your situation to determine which parts should comprise your healthcare directive. If you are uncertain how to proceed, consult with an attorney.

Scenario #1: You are willing and able to write down your preferences, and you have at least one person you can trust as your agent.

Write a complete healthcare directive.

This is the most comprehensive approach, and is highly recommended to control your future medical care. It offers the greatest likelihood that your wishes will be honored.

First, take the time to write meaningful guidelines for your care so that your treatment wishes can be honored and your decision-makers feel supported. Clearly expressing your healthcare preferences requires more than a checked box. Secondly, legally empower your healthcare agents by completing the healthcare power of attorney document. Choose your agents wisely by carefully considering the critical traits required for your healthcare agents to serve your interests.

Scenario #2: You are unable or unwilling to write down your preferences, but you have at least one person you can trust as your healthcare agent.

Write only a healthcare power of attorney to select your healthcare agent(s).

This is appropriate if you are unwilling or unable to write down your instructions. You may prefer to verbally express your preferences, or you may simply trust that your selected agent will make decisions in your best interest.

Recognize that this approach can add tremendous stress for your healthcare agents. Consider taking the time to write down your instructions and complete an entire healthcare directive (approach for scenario #1). If you are unable to write or type your wishes, consider using a tape recorder and having your recording transcribed into your healthcare directive. Numerous transcription services are available via the Internet.

Scenario #3: You are willing and able to write down your preferences, but you have no one you can trust as your agent.

Write only your healthcare instructions.

Your instructions state what kinds of treatments you want to receive and treatments you want to refuse in various circumstances. If you do not have a person you fully trust to name as your agent, you should carefully write down your instructions so the medical professionals treating you will know your preferences. In this case, it is imperative that your physician receives a copy of your directive so that your treatment preferences can be honored by your medical team at the end of life.

Recognize that a decision-maker can be named to fill this vacuum. The attending physician could be approached by a loved one who qualifies as next-of-kin, asking to serve as your surrogate. The physician could appoint a family member to make the decisions. A court can name a guardian or conservator.

If this is your circumstance, you might consider broadening your search for a healthcare agent. Perhaps an attorney, clergy person, respected friend, neighbor, or business colleague could be chosen as your agent. However, if you truly do not have a trusted advocate, do not name anyone as your agent.

If the End Is Near

If you are facing the possibility of your passing within the next twelve months, speak with your physician about also writing doctor’s orders, which may include a P.O.L.S.T. (Provider Order for Life Sustaining Treatment) and/or a D.N.R. (Do Not Resuscitate) order. Either of these documents can strengthen your end-of-life wishes in the form of a medical order.

Which form should you use?

The resources page of my website offers suggestions on widely adopted directive forms. Additionally, my book can guide you to write a meaningful healthcare directive. Finally, this infographic can inspire you to write an effective healthcare directive.

QUESTION: April 16th is National Healthcare Decisions Day. This is a day set aside to encourage all adults to write a healthcare directive. If you have written your healthcare directive, will you please share this article via social media with your comments to inspire others to make their end-of-life wishes known?


You can prepare for the responsibility of serving as the healthcare agent for one or both of your parents.

This FREE guide will help you to prepare for the future possibility of making medical and personal care decisions for your Mom or Dad. Interested?

Click here to download your copy
Healthcare Agent Preparation Guide

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