What is an Advance Directive?

This is part of Cake’s collection of articles on advance care planning. Create your free Cake profile today to discover, document, and share your end-of-life wishes.

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We understand that making end-of-life care decisions for a loved one can be difficult and painful. By creating an advance directive, you give your family the gift of knowing they are doing what you want. Advance directives spell out your medical choices so your loved ones don’t have to guess.

At Cake, we are passionate about helping guide you through all of the end-of-life planning you need with our free planning platform. Part of your essential checklist will be a state-specific advance directive to make sure you get the medical care you need and want at the end of your life.

What are advance directives?

The term “advance directives” generally refers to two common documents that help you express your wishes for medical care at the end of life.

  • Living Will: This document details your end-of-life healthcare decisions in writing. This includes decisions like whether or not to be put on a ventilator, have a feeding tube, or be resuscitated.  Learn more about living wills.

  • Health Care Proxy: Allows you to appoint a trusted person to make medical decisions for you if you cannot express yourself due to incapacity or impaired decision-making ability. Your health care proxy and doctors will use the decisions in your living will as a guide for what to do when choices need to be made to either prolong life or focus on comfort instead. Learn more about choosing a good health care proxy.

Most US states combine these two documents into one, simply referring to the joint document as an “Advance Directive.”

What does an advance directive do?

Advance directives can go by other names such as advance healthcare directive or medical directive. No matter the name, they exist to provide your medical care team and family with a guide to your medical decisions when you can’t speak for yourself due to unconsciousness or an inability to make decisions (e.g. dementia). Making decisions to withhold care can be truly difficult for your loved ones if they don’t have your preferences in writing.

Other names for an Advance Directive:

  • Advance Healthcare Directive  
  • Life-Prolonging Treatment Form
  • Living Will
  • Medical Directive
  • Personal Directive
  • Personal Wish Statement

Why do people make an advance directive?

Health care choices at the end of your life or in circumstances where you can’t speak can greatly impact the quality of life you have for your remaining time. Some people prefer to live as long as possible while others might consider choices that leave them with a higher quality of life even if it shortens the time they have left

By filling out an advance directive, you can ease the minds and burdens of your loved ones during a difficult time. You will have already made the hard decisions so they won’t have to. This can reduce family conflict and feelings of guilt that arise when decisions have to be made without knowing your preferences. You’ll also ensure you receive the level of care you want, even if you can’t speak for yourself.

Do I need an advance directive?

Yes! All adults, healthy or ill, young or old, should create an advance directive. We never know what life has in store. Accidents happen. Illness and surgeries increase our risk of needing an advance directive. It's a responsible act to plan ahead for the care you do or do not want to receive. By planning ahead, you'll also unburden your family from making tough decisions when the time comes someday.

How do I create an advance directive?

Head over to Cake’s 50 States Advance Directive Resource where you can download your state’s forms. Once you’ve completed your forms, upload them to a free Cake account where you can finish all your end-of-life planning and share your documents with family.