Advance Directives, Living Wills, and Healthcare Proxy Explained

These three terms get used somewhat interchangeably, but understanding how they actually relate to each other helps you make sure you have the right documents in place.

What is an advance directive?

An advance directive is a general term covering legal documents that state your healthcare wishes in advance — it can include a living will, a healthcare proxy designation, or both together in one document, depending on your state’s specific forms.

What is a living will?

A living will specifies which medical treatments you do or don’t want in specific situations — for example, whether you’d want life-sustaining treatment if there’s no reasonable chance of recovery. This document speaks directly to situations it addresses, but can’t anticipate every possible scenario.

What is a healthcare proxy?

A healthcare proxy (sometimes called a medical power of attorney) names a specific trusted person to make medical decisions on your behalf if you can’t communicate them yourself. This person can use their judgment for situations your living will doesn’t specifically cover.

Most people benefit from having both, not just one or the other.

Is a healthcare proxy the same as a medical power of attorney?

These terms are often used interchangeably, though exact terminology varies by state - both generally refer to naming someone to make medical decisions on your behalf.

Can I change my advance directive later?

Yes - these documents can typically be updated at any time as your wishes or health situation changes, and it’s worth revisiting them periodically.

If someone has dementia, timing matters; see our guide on whether someone with dementia can still sign a will or power of attorney.

Do I need both a living will and a healthcare proxy?

Most experts recommend having both. A living will alone can’t cover every possible medical scenario. A healthcare proxy alone doesn’t give that person specific guidance on your actual wishes. Together, they cover both the specific situations you can anticipate and the ones you can’t.

Do I need a lawyer to create these documents?

Not necessarily. Many states provide free, legally valid advance directive forms — often available through a hospital, state health department, or organizations focused on advance care planning. A lawyer can help if you’d like something more customized to a complex situation.

What should I do next?

Start with your state’s free advance directive form - a hospital, state health department, or advance-care-planning organization can usually point you to it. Fill out both the living will and healthcare proxy sections if the form combines them, or complete both documents separately if your state keeps them apart. Then talk with whoever you’ve named as your proxy, so the choice isn’t a surprise to them, and give copies to your doctor and close family.

Add this to your Final Day Plan: who you’ve named as your healthcare proxy, and where the signed documents are kept - in an emergency, your family needs to find these quickly, not search for them.

If you’re unmarried or rely on chosen family, see hospital visitation and medical decisions for unmarried partners and LGBTQ+ elders and end-of-life planning.

If there is no proxy and the person can no longer decide, see Making medical decisions when a parent with dementia can no longer decide and Guardianship and conservatorship for adults.

For the difference between refusing treatment and medical aid in dying, see what is medical aid in dying.

Specific requirements and terminology vary by state. This is general educational information, not legal advice — consider consulting an attorney for guidance specific to your state.

If someone has been diagnosed with dementia, completing these documents while they still have the capacity to do so is especially urgent; see our guide on how dementia ends and what families can expect.