What is a Health Care Directive/Advance Directive/Living Will?
A Health Care Directive (also known as an Advance Directive or Living Will) is a legal document that allows you to express your health care instructions ahead of time, particularly those at the end-of-life, should you become unable to voice your wishes. This document applies only if you are in a terminal or permanently unconscious condition and wish to give direction on whether you would want to be kept alive through artificial means. Through creation of this document, you are able to relieve your loved ones of having to make these difficult decisions.
Is a Health Care/Advance Directive the the same thing as a DNR (Do Not Resuscitate) or a POLST (Physician Orders for Life-Sustaining Treatment) form?
No. A Health Care Directive, POLST, and Do Not Resuscitate (DNR) order are three similar but different documents that serve different purposes.
A Health Care Directive is a legal document that allows you to state your wishes about life-sustaining treatment if you are unable to communicate and are in an end-of-life condition. It also provides guidance to your loved ones and medical providers during difficult medical decisions.
A POLST (Physician Orders for Life-Sustaining Treatment) is a medical order completed with your healthcare provider. It is generally intended for individuals with a serious illness or advanced frailty and communicates their wishes regarding CPR, hospitalization, and other life-sustaining treatments. Because it is a medical order, emergency personnel and healthcare providers follow it immediately.
A Do Not Resuscitate (DNR) order is also a medical order completed with your healthcare provider. It specifically instructs emergency medical personnel and other healthcare providers not to perform CPR if your heart stops or you stop breathing. A DNR addresses only resuscitation and is much more limited in scope than a POLST.
While these documents may work together, they serve different purposes. An estate planning attorney typically prepares your Health Care Directive, while a POLST or DNR is completed with your physician or other qualified medical provider.
Do I need a Health Care Directive and a DNR and/or POLST form?
Most adults should have a Health Care Directive. A Health Care Directive is an important part of every estate plan and allows you to communicate your wishes regarding life-sustaining treatment if you are unable to speak for yourself.
A POLST or Do Not Resuscitate (DNR) order may also be appropriate, but they are not necessary for everyone. These medical orders are typically recommended for individuals with a serious illness, advanced frailty, or other medical conditions where decisions about emergency treatment need to be communicated immediately to healthcare providers and first responders.
Because a Health Care Directive and a POLST or DNR serve different purposes, one does not replace the other. If your physician recommends a POLST or DNR, it is generally advisable to have both your Health Care Directive and the appropriate medical order in place.