What is an advance directive?

An advance directive is a legal document that gives instructions for your medical care and takes effect only if you cannot communicate your own wishes. The National Institute on Aging says the two most common are the living will and the durable power of attorney for health care, which names a health care proxy. Many states have free forms, and a lawyer is helpful but not required.

Dementia gradually takes away the ability to make decisions, so planning early lets the person take part. The National Institute on Aging notes that Alzheimer's and related dementias are terminal conditions and encourages families to discuss care wishes as early as possible. The Alzheimer's Association says end-of-life wishes should ideally be discussed while the person can still make decisions about life-sustaining treatment.

A living will is one kind of advance directive. The National Institute on Aging explains that a living will tells doctors which treatments you would want or avoid if you cannot decide, while a durable power of attorney for health care, another advance directive, names a proxy to decide for you. You can have either or both. NIA suggests reviewing them at least once a year.

An advance directive is legally recognized but not legally binding, the National Institute on Aging says. Doctors and the health care proxy will try to respect it, but there may be situations, such as a complex medical problem where your wishes are unclear, when they cannot follow it exactly. That is why talking about your preferences with family and your proxy ahead of time matters.

An advance directive is your own legal statement of wishes, while a POLST is a medical order signed with a health care professional. The National Institute on Aging says POLST and MOLST forms give guidance professionals can act on immediately in an emergency, and are typically created near the end of life or during critical illness. They add to an advance directive rather than replace it.