Advance Directives and Living Wills: A Plain Guide
An advance directive answers a question none of us wants to imagine: if you couldn't speak for yourself, who decides, and what would you want? Families who have these documents describe the same relief — in a terrible moment, they weren't guessing, and they weren't arguing. The good news is that advance directives are free to create, you don't need a lawyer, and it takes an afternoon. Here's what the pieces are, and how to make yours count.
Quick answer
An advance directive is a legal document that takes effect only if you can't make or communicate your own medical decisions. The two main kinds are a living will (which treatments you would or wouldn't want) and a healthcare power of attorney / proxy (the person who decides for you). You can create both for free without a lawyer. A POLST/MOLST is a separate medical order for people who are seriously ill. Laws and forms vary by state, so use your state's form and store it where it can be found.
What an advance directive is
An advance directive is a set of legal documents that only take effect if you become unable to make or communicate your own medical decisions — after a serious accident or illness, for example. While you can still speak for yourself, you remain in charge; the directive simply waits in the background as your backup plan and your voice.
A plain-English guide, not legal or financial advice
This article explains how these rules generally work so you can ask better questions — it isn't legal, financial, or tax advice, and the details vary. For your own situation, check the primary sources linked below and, where it matters, work with a qualified attorney or advisor.
The two main pieces: a living will and a healthcare proxy
- A living will states which medical treatments you would or wouldn't want — things like resuscitation, mechanical ventilation, tube feeding, or comfort-focused care — and under what conditions. It speaks for you about the care.
- A healthcare power of attorney (also called a healthcare proxy or agent) names the person who will make medical decisions for you when you can't. This is the same document discussed in our guide to powers of attorney — the healthcare side of it.
Most people want both: the living will guides the decisions, and the proxy is there to handle the many situations no document could anticipate.
You don't need a lawyer — and it's free
This is the part that surprises people. You can complete advance directives yourself, at no cost. There are free, plain-language tools to walk you through it — the NIA-funded PREPARE for Your Care program offers free advance directives in English and Spanish, and many states publish their own free forms. A lawyer can help if your situation is complex, but they aren't required.
POLST and MOLST: a different document for serious illness
You may run into POLST or MOLST (Physician/Medical Orders for Life-Sustaining Treatment). These are not the same as an advance directive — they're actual medical orders, signed by a clinician, that emergency responders and hospitals can act on immediately. They're meant for people who are seriously ill or near the end of life, and they supplement an advance directive rather than replace it. If you're generally healthy, a living will and a healthcare proxy are what you need now.
Medicare covers advance care planning
You don't have to do this alone. Medicare covers advance care planning as part of your yearly 'Wellness' visit — a chance to talk through your wishes with your doctor and get help completing your directive. It's one of the simplest ways to start.
Where to keep it (and where not to)
A directive nobody can find in an emergency doesn't help. The guidance is consistent:
- Keep the original somewhere safe but easy to reach — not in a safe-deposit box, which your family may not be able to open in time.
- Give copies to your healthcare proxy, your doctor, and close family.
- Take a copy to the hospital any time you're admitted.
- Carry a wallet card noting that you have a directive and who your agent is.
- Check whether your state has an advance-directive registry.
Keep it current — and re-check it if you move
Review your directive after any major life change — a diagnosis, a divorce, the death of the person you named as proxy. And because advance-directive laws and accepted forms vary by state, a document valid where you signed it may need to be redone if you move. Recording where the current version lives — and who has copies — is exactly what an end-of-life planner is built to do.
You may be interested in…
Ultimate End-of-Life Toolkit
An advance directive only works if someone can find it. This three-in-one toolkit keeps your directive, accounts, and medical details together so your wishes are actually reachable in a crisis.
End of Life Planner
The End of Life Planner records where your advance directive and healthcare proxy are kept, who your agent is, and the wishes your family may need to honor — the map that makes sure the document you completed is found and followed.
Emergency Binder
In the ER, minutes matter. The Emergency Binder keeps your directive, medications, doctors, and emergency contacts in one place the people helping you can grab.
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Good to know
Common questions
What is the difference between a living will and an advance directive?
'Advance directive' is the umbrella term for documents that state your medical wishes if you can't speak for yourself. A living will is one type of advance directive — it specifies which treatments you would or wouldn't want. The other main type is a healthcare power of attorney, which names the person to decide for you. Most people complete both.
Do I need a lawyer to make an advance directive?
No. You can complete advance directives yourself for free, using your state's form or a free tool like the NIA-funded PREPARE for Your Care (available in English and Spanish). A lawyer can help with complex situations but isn't required to create a valid living will or healthcare proxy.
What is a POLST or MOLST, and is it the same as a living will?
No. A POLST or MOLST is a medical order signed by a clinician that emergency and hospital staff can act on immediately. It's intended for people who are seriously ill or near end of life and supplements — not replaces — an advance directive. A generally healthy person needs a living will and healthcare proxy, not a POLST.
Where should I store my advance directive?
Somewhere safe but easy to find — not a safe-deposit box, which family may not be able to access in an emergency. Give copies to your healthcare proxy, your doctor, and close family; take a copy to the hospital if you're admitted; and carry a wallet card naming your agent. Some states also have an advance-directive registry.
Does an advance directive from one state work in another?
Not always. Advance-directive laws and accepted forms vary by state, so a directive valid where you signed it may need to be redone if you move. Review your documents after any move or major life change, and use the current form for the state where you live.
Once your wishes are written down
Make sure they'll be found and followed
The End of Life Planner records where your advance directive lives, who your healthcare proxy is, and the wishes your family may need to act on — so the afternoon you spent on this actually protects you when it counts.
See the End of Life Planner →