Most People Do Not Have Advanced Health Directives...And They Should

After researchers reviewed data from 150 studies conducted on almost 800,000 people between 2011- 2016 they found that only 36% had completed advance directives and for 29% of them, it was a living will. The results of the study were published last week in the journal Health Affairs.

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Advance directives is not a comfortable topic of conversation for many people. So, the low rates of completed documents found in the study above comes as no surprise.   An advance directive is an umbrella term that covers different types of written, legal documents used to guide your health care if you become incapacitated. The two main documents are a living will and medical power of attorney. Other advance directives can include documents for do not resuscitate orders, organ donations, feeding tube insertion, and blood transfusions.

To help clarify the differences between the most important of these document -

A Living Will is a written legal document that informs medical personnel of the types of treatment you want if you are dying, unconscious, or otherwise incapacitated and cannot make emergency health care decisions. A living will indicates your wishes about being resuscitated, put on a ventilator, or having a feeding tube inserted.

A Medical Power of Attorney  or health care power of attorney is a written legal document that specifically names someone (called a health care proxy, surrogate, or health care agent) to make medical decisions for you at times when you are not able to make those decisions for yourself. The person you choose will be speaking for you should the situation arise, so he/she should know what you would want done. A medical power of attorney covers more than a living will does, so it can be used instead of, or in addition to a living will.

Having a medical power of attorney is not just for older people or people with life threatening illnesses. It is particularly important for parents when their children turn 18. Once a child turns 18, he/she is legally an adult. With this birthday, parental rights to medical information and to make medical decisions, vanish. What this means is - if your 18 year old child is lying in an emergency room, you have no right to any information about his/her condition or any right to make medical decisions. HIPPA privacy rules in fact, make it illegal for medical personnel to share information with you once your child turns 18.

Other documents

DNR – Do Not Resuscitate – informs medical personnel that you do not wish to have your heart
“shocked” or restarted if it stops beating or is beating so abnormally that it is life threatening.

Organ and tissue donation - informs your family/significant others and medical personnel of your wishes to donate organs or tissues for transplantation.

Durable Power of Attorney – gives someone else the power to conduct your business on your behalf. For example, sign checks for you to pay bills, sign tax returns, access your bank account.

There are a number of websites with “do it yourself” legal forms, including those for advance directives. Just make sure you use the ones for your state and follow the instructions exactly. Given the complexities of the law and minor nuances of each state, a better option is to seek out the services of an attorney who specializes in elder law, even for your 18 year old’s medical power of attorney.  The emergency room is the last place you want to find out that the document you have is useless.

For more information

NIH – National Institute on Aging
Advance Care Planning Tips

Mayo Clinic
Living wills and advance directives

Advance directive



Joanna Hayden, PhD, CHES is the principal of Associates for Health Education and Behavior, LLC, in Sparta, a practice focused on improving health through education. Her office offers individual and group health education, and individual health behavior change guidance.  For more information please see  To contact Dr. Hayden, email her

The opinions expressed herein are the writer's alone, and do not reflect the opinions of or anyone who works for is not responsible for the accuracy of any of the information supplied by the writer.

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