Owing to advances in medical technology, people’s lives can be sustained even when they are terminally ill and have no hope of leading an active, independent life. An advance directive is a document in which you give instructions about your health care and what you want done and not done if you can’t speak for yourself. Advance directives are not complicated, typically consisting of short, simple statements expressing your values and choices. “Advance directive” is a term that includes health care directives, living wills, health care (medical) powers of attorney, and other personalized directives. 

• Health care directive. A health care directive is a type of advance directive that tells you doctor and your family members what kind of care you would like to have if you become unable to make medical decisions. Unlike most living wills (described next), a health care directive is not limited to cases of terminal illness. If you cannot make or communicate decisions because of illness, a health care directive helps you keep control over health care decisions that are important to you.
  

• Living will. A living will is a form of advance directive that usually only comes into effect if you are terminally ill, which generally means you have less than six months to live. It is important to note that not all states recognize a living will as a legal document.
  

• Health care (medical) power of attorney. A health care (medical) power of attorney, also known as a health care proxy, lets you name someone (an “agent”) to make medical decisions for you if you are unconscious or unable to make medical decisions for yourself for any reason. It may be incorporated within a health care directive or living will or it may be a separate document. Appointing an agent is particularly important. At the time a decision needs to be made, your agent can participate in discussions and weigh the pros and cons of treatment decisions based on your wishes. Your agent can decide for you whenever you cannot decide for yourself, even if your decision-making is only temporarily affected.
  

An advance directive, including a health care (medical) power of attorney, has no legal effect unless and until you lack the capacity to make health care decisions or to give consent for care. By expressing your wishes in advance, you help family or friends who might otherwise struggle to decide on their own what you would want done, a point that was amply illustrated by some well-publicized cases where end-of-life decisions could not be made, to the detriment of the patient. Finally, advance directives aren’t just something for old folks. The stakes are actually higher for younger people in that, if tragedy strikes, they might be kept alive for decades in a condition they would not want.

Everyone should consider preparing an advance directive; it can provide comfort to family members at a difficult time. Also (forgive me, but this is a financial commentary), an advance directive can save a lot of money. The cost of keeping someone alive by artificial means can drain a family’s estate particularly if this is not the loved one’s wish.

Finally, each state has adopted its own nomenclature for these important directives, so it behooves you to work with an attorney who is familiar with the regulations in your state.