Step by Step Overview: How to Create an Advance Directive

Making an advance directive can seem overwhelming at first. However, once you learn some of the common terminology and become familiar with your necessary state forms, it is pretty straightforward. The most difficult part is really the thought you put into your medical wishes and the conversations you have with your medical decision makers (usually your family). Here is a basic step-by-step guide to creating your advance directive.

1. Choose your Medical Power of Attorney (POA) and back-up POA. This person is most commonly your spouse, or adult child(ren), but can be a non-relative. Read more about selecting your POA here.
2. Think about the type of medical care you would want if you became critically ill. This can be the hardest step for someone who is not experienced with end-of-life medical care, but there are lots of great resources out there. Ultimately, this is a conversation about personal values and what is important to you in your everyday life.
   1. Tools for these questions — My Five Wishes ($5, available here), The Conversation Project (free, learn more here) , Cedars Sinai Advance Directive (free, learn more here). Look at these resources and think about their thought-provoking questions.
   2. Name your “Litmus Test.”
3. Talk to your Primary Care Physician about any questions you have. This is best done at its own an appointment so that you are not rushed. You can even bring your POA with you if you would like.
4. Discuss the kind of medical care you would want and your Litmus Test with your POA(s)
5. Complete your state Advance Directive form
   1. Available forms listed by state from the AARP
   2. Forty Four (44) states currently accept the My Five Wishes document (link above). The list of states can be found here. This might be an easier alternative for you.
6. Talk to your physician about creating a MOLST/POLST/POST/MOST form for your state (more info). You can find the form for your state here. This is also where you will find a Do Not Resuscitate (DNR) order if you would like to complete one. Rest assured, the default for healthcare workers is to attempt a resuscitation if you do not have a signed DNR order.
7. Ensure all your forms are signed, witnessed, and notarized (if required by your state)
8. Give a copy of your advance directive to your POA, back up POA, Primary Care Physician, Attorney, and have a copy somewhere very accessible in your home.

You’re done! The MOST important part of this whole list is the *discussion* you have with your POA, even if it is *just* to tell them your Litmus Test.