An advance directive helps avoid confusion about what kind of care you want, how far providers should go in delivering that care, and who gets to decide what your care looks like. Anyone over 18 has the legal right to create an advance directive.
Advance care planning guides you through the process of making these choices. Here’s what you need to know before you fill out the advance directive form.
Stop: Before You Fill Out an Advance Directive Form
Many people don’t realize all the things that need consideration. Advance care planning involves deciding:
- Who will make healthcare decisions for you, if you can’t
- What kind and amount of medical care you want for certain situations
These are big decisions. Take time to make them, so that you feel confident in your decisions.
Why Should You Plan in Advance?
You may face a time, due to injury or illness, when you can't communicate what you want. That means you won’t be able to make your own healthcare choices. You’re leaving the control up to others.
That’s where advance care planning comes in. You set up your plan ahead of time and share it. That way you get the care you choose even when you can't tell us yourself.
What You Need to Decide & Do: The Advance Care Planning Process
Advance care planning involves:
- Choosing a healthcare decision-maker or agent
- Deciding the level and type of care you want
- Filling out 1 or 2 forms that outline your decision
- Getting your forms signed by yourself and 2 others, as witnesses
- Discussing your decisions with your family, caregivers, friends
- Giving copies of your forms to UVA Health
A Few Words to Know
Advance care planning guides you through the process of making these choices.
Advance Directives or Advance Medical Directives or Power of Attorney are legal documents that communicate your healthcare choices.
Healthcare Agent or proxy is the person you decide to make healthcare decisions for you if you can’t do it yourself.
Step 1: Choosing a Healthcare Agent
Your healthcare agent is a decision-maker who’ll make the same choices you would. It’s important to talk to them about what matters most to you. This way you have control over the healthcare you receive, no matter what.
Legally, this is sometimes called a Power of Attorney for Healthcare.
How Do I Choose a Healthcare Agent?
When choosing a healthcare decision-maker, pick someone who:
- Will speak up for you when you can’t
- Is willing to discuss the decisions you’d want if you were seriously sick or hurt
- Will respect and follow your decisions
- Can stay calm and communicate clearly in stressful times
- Can make sure your loved ones and healthcare team understand your choices
What Should My Healthcare Agent Know?
When choosing a healthcare decision-maker, talk with them about your thoughts and choices. This can help you reach your own decisions about your care.
Tell your agent what kind of physical and mental ability you need to have to want to live. You may want all possible medical treatments if they can help you recover well. But if recovery isn’t likely or treatment becomes too hard, you might want to focus on comfort and quality of life instead of suffering longer.
Why Do I Need an Official Healthcare Agent?
If you don’t choose a healthcare decision-maker in a legal document, and you don't have a court-appointed guardian, Virginia law lists those responsible in this order:
- Your spouse (even if you're separated, unless a divorce is filed with the court)
- Your adult children (all must agree)
- Your parents — both of them must agree
- Your adult siblings (all must agree)
- Other blood relatives (like aunts, uncles, nieces, nephews, or cousins)
How to Officially Appoint a Healthcare Agent
You list your chosen healthcare agent in an advance directive form. You must sign the advance directive in front of 2 adults. They must also sign the document.
Step 2: Make Your Healthcare Choices
You’ve chosen a trusted healthcare agent. Now it’s time to choose the medical treatments you want in certain situations. Your agent can help you consider your options.
Questions that you might talk about include:
- If you become so ill that treatment that you won't have a full recovery, would you prefer more time or a better quality of life? Would you want to live longer at any cost or be pain-free at any cost? Would you want care that gives you more time or care that relieves symptoms?
- What abilities are so important that you can't imagine living without them?
- If you were very ill, what wouldn't you want to go through for the chance of more time?
- What gives you strength when you think about your future?
- What are your biggest fears and worries about your health?
- What are your most important goals if your health gets worse?
- What experiences have you had with people who’ve been seriously ill? What have they taught you?
Always make sure everyone understands exactly what your choices mean when thinking through or discussing specific healthcare situations.
Step 3: Fill Out an Advance Directive
You have 2 forms you can fill out and share.
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Healthcare Agent-Only Form Why you would choose this: If you want to only designate a healthcare agent.
Download the healthcare agent form (PDF) |
Full Advance DirectiveForm Why you would choose this: If you want to designate a healthcare agent AND list out more details and information about the decisions you want made about your care.
Download the standard advance directive form (PDF)
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Step 4: Sign the Form
You'll need to sign the form, of course. You also need two other people to watch you sign the form. They will also sign it. This legal step is to make sure that no one else creates and signs a form pretending to be you.
Step 5: File the Form with UVA Health
If we don’t have your advance directive form, we can’t follow your plan. So make sure that you file your form with us and with all of your healthcare providers.
You can:
- Upload to MyChart
- Give to someone at your next clinic or hospital visit (registration or provider)
You might also give a copy to your healthcare agent.
Step 6: Discuss Your Decisions With the People in Your Life
An upfront conversation with the people in your life can prevent confusion in case of an emergency.
Our advice: Review and share copies of your advance directive with the people in your life. Make sure everyone understands:
- The identity of your healthcare decision-maker
- Where your forms are filed
- The choices you’ve made
What if You Change Your Mind?
Life changes and time can impact your choices. If you change your mind, you can make a new advance directive. Your healthcare decisions are always up to you.
We recommend looking at your advance directive on a regular basis to make sure it’s still what you want.
Review your advance directive when you:
- Experience the death of someone close to you
- Divorce
- Get a serious diagnosis
- Decline in your mental or physical health
- Go for 10 years without looking at it
You can make a new advance directive at any time. We’ll follow the document with the most recent date. Just be sure to give us the most recent version, so we can get it into your medical record.
Advance Care Planning at UVA Health
At UVA Health, we respect your healthcare choices. We’re committed to respecting advance directives outlining your choices for treatment and care. We put the patient at the center of all we do. That means every patient – you.