Advance Directives

What are advance directives?

An advance directive is a written instruction that you make while you are mentally competent that
states how you want your health care decisions to be made if you become incapacitated or cannot
express your wishes. Advance directives guide your physician and other health care professionals,
and relieve your family from the burden of guessing what types of care and treatment you would
want to receive.  

Advanced Directive Information from the
Alabama Bar Association

Additional resources:

Five Wishes  is an advance directive that covers more issues than a typical living will or power of
attorney document. The document, which meets legal requirements in more than 40 states (see
note 1 below) , lets physicians and a patient's family know:

•who should make health care decisions for a patient when they can't;
•medical treatment they want (or don't);
•how comfortable they want to be;
•how they want to be treated; and
•what they want loved ones to know.

Let Me Decide is an advance directive book written by a geriatrician. Each book contains a four-
page form designed to clearly state patient's wishes, as well as a sample form. The author
encourages patients to consult their health care professional before completing the document.
The document is designed to:

•give individuals the opportunity to choose different levels of treatment according to wishes;
•relieve family and friends from the burden of decision making; and
•guide physicians in making important decisions when family members are unavailable.

Physician Orders for Life-Sustaining Treatment (POLST), uses a form that converts patient
preferences into written medical orders based on a health care professional's conversation with the
patient and/or a proxy. POLST programs have been implemented in at least a dozen states and are
in development in at least 20 more. offers resources for patients, including information about advance directives and
do-not-resuscitate orders.

It’s Ok to die if you are prepared - Whether you are making plans for yourself or assisting
someone, preparing in advance will help relieve the burden for all involved. Preparation provides
opportunities for peace, closure and even healing. At, their goal is to educate and
empower you with tools, checklists and resources.

(1) Clarification about Five Wishes.  Even though there is federal law that requires health care providers to honor
any expression of your wishes, these matters are most often decided in the states themselves, so state law is our
guide.  Thus, we take a very conservative approach in deciding whether or not a state is “Five Wishes state.”  
Alabama is one of the states where there is some uncertainty in the law, saying that living will and health care
power of attorney forms be “substantially in the following form.”  Many Alabama health care providers and others
prefer to play it safe and go with just the state-provided forms, in effect forcing residents to use government forms to
express their own wishes.  As a practical matter, in 16 years and 18 million copies of Five Wishes in national
circulation (including Alabama) we know of no instances anywhere where a health care provider has not honored
Five Wishes.  Usually the problem is the absence of an advance directive, not the wording on one.  We advise
people in non-Five Wishes states to complete Five Wishes and attach it to the signed state form.  


Edward J. Towey
Director of Communications
Aging with Dignity