What is an Advance Directive and How Do I Get Started?

Resources for easy advance care planning

Advanced Directive

Does your family know what to do if you ever became seriously ill and couldn’t communicate your medical wishes?

If not, you can spare everyone a lot of heartache by having an advance directive in place. 

An advance directive is a legal document that outlines your medical decisions ahead of any major illness or accident. 

Though it can be a difficult topic to bring up with family members or friends, you’ll be grateful you have one in place, should the unthinkable happen. 

What are the benefits of having an advance directive?

If you’ve ever been in a situation where you had to make life-altering decisions on behalf of another person, you know how important having an advance directive can be. The benefits extend not only to patients but to family members and caretakers as well. 

And in the era of COVID-19, having an advance directive in place is especially important.

“Life is unpredictable,” said Cathleen Obray, MD, an internist at the Intermountain River Road Internal Medicine Clinic. “A motor vehicle accident, head trauma, COVID-induced pneumonia, or even a fall could leave you unable to make decisions about the medical care you receive. An advance directive ensures that if you are unable to clearly communicate your own wishes, that they are still honored. It can alleviate a great burden to family and loved ones to have made these decisions in advance of tragedy or illness.”

Who needs an advanced directive?

If you’re relatively young and healthy, you might not think you need an advance directive. But planning for the future isn’t just for the sick or elderly.

“Every adult over 18 years of age should have an advance directive,” said Obray. “An advance directive ensures that your wishes are honored even when you may be too ill or too injured to express them yourself to your healthcare team.”

While life can be unpredictable, your healthcare shouldn’t be. 

What should you consider when planning for advanced care?

When planning for advance care, take your time and be thorough as you consider your wishes for the future. Here are a few things to keep in mind:

  • Living arrangements. Do you want to remain in your own home? A care facility? Think about where you’d be most comfortable. 
  • Day-to-day assistance. If you’re unable to perform certain functions, do you want a live-in caregiver? Or would you prefer someone to visit your house? 
  • Medication. Who will be responsible for overseeing your medication?
  • Finances. Who will be in charge of your assets and make financial decisions for you?
  • Other healthcare decisions. Everything from organ donation to power of attorney and medical interventions should be decided as part of your advance directive planning. 

Who should you assign to be your healthcare agent?

A critical component of your advance directive is choosing someone to be your healthcare agent. This person will make healthcare decisions for you if you’re unable to make them yourself. 

While healthcare agents are often spouses, adult children, or parents, your agent can be any adult you feel will represent you best. 

“Agents don’t need to live locally,” said Obray. “What is perhaps most important, however, is that whomever you choose to be your agent knows your wishes and will honor them under distress; even if they disagree. Letting your agent -- and ideally all of your loved ones – know who your agent will be is also important. This helps ensure that your wishes are honored and that loved ones can be at peace with tough decisions that may need to be made.”

RELATED ARTICLE: Advance care planning is a gift to your family

Can you make changes to your advance directive?

Yes! It’s a good idea to review your documents each year, especially if you experience any major life events (divorce, loss, a new medical diagnosis, death of an agent, etc.). These factors can influence your medical wishes.

If you’re over 65, you may want to review your advance directive and healthcare goals with your primary care provider during your annual wellness visit. 

To make changes to your directive, follow the instructions on the Utah Advance Health Care Directive form

Who keeps a record of the advance directive?

While you can keep a record of your wishes in the family filing cabinet or sock drawer, you shouldn’t stop there. 

“It's important to keep a copy at home but also to provide a copy to your healthcare provider and local hospital,” said Obray. “For anyone living in Utah, we recommend providing Intermountain Healthcare with a completed copy to be stored with your electronic medical record. This way it will be readily assessable if you find yourself in the emergency room and unable to communicate your healthcare wishes.”

When you file an advance directive at one Intermountain facility, it becomes part of your electronic medical record and is available at all Intermountain facilities. You can submit an advance directive at any Intermountain medical records department in-person, or by mail, email, or fax. 

RELATED ARTICLE: Using advance directives to define the care you want

How to get started

While it’s never too early to make a plan for future medical care, it’s possible to be too late. Don’t let that happen to you or your family members. 

To get started with advance care planning, begin by having a discussion with those closest to you. Consider experiences you’ve had with seriously ill or injured loved ones when deciding what types of situations you want to avoid. Sharing these goals and wishes with friends and family will go a long way toward ensuring your wishes are carried out. 

For more information, Intermountain's resource page on advance care planning. You’ll find helpful resources about the advance planning process, including how to start the conversation with your loved ones.