Advance directive

A written document specifying a patient's wishes for end-of-life medical care — typically covering CPR, mechanical ventilation, artificial nutrition, and other interventions when recovery is unlikely. Combined with a healthcare proxy, this is the core advance-care-planning package.

What it means in practice

The advance directive answers the questions a clinical team will ask the family — sometimes urgently — when the patient is too sick to answer for themselves. The standard topics: CPR (chest compressions, defibrillation, intubation), mechanical ventilation, artificial nutrition and hydration, antibiotics for new infections, hospice referral, and organ donation. Each is a yes/no/conditional, and the document records the patient's preferences before the moment of crisis when those preferences are hardest to articulate.

Each state has its own official form. The 51 states + DC each have specific witness, notarization, and content requirements — a document valid in one state may not be valid in another. For families with a parent who spends time in multiple states, signing the official form for each state is the cleanest path. Practically, most hospitals will honor any reasonable directive (even from a different state) as long as it's clearly the patient's wishes — but bringing the right form removes any ambiguity at admission.

The directive is meaningful only if the clinical team SEES it. Storing it in a safe-deposit box defeats the purpose. The family workspace, the patient portal, the wallet card, and the patient's phone all matter — the family caregiver should make sure at least 2-3 of these channels carry a copy. Kintaria's document vault and share-with-provider link are designed for exactly this hand-off.

When you'll hear it

Should be set up while the patient has capacity. Hospitals ask about it at admission. Many states have official advance-directive forms; some require notarization or two witnesses for validity.

Is this the same as…?

Terms families frequently confuse with advance directive.

Related terms

• Healthcare proxy — A legal document naming a person to make medical decisions if the patient cannot.
• DNR — A medical order signed by a physician (not just a patient request) that CPR will not be attempted if the heart stops.
• POLST / MOLST — A standardized medical-order form, signed by both patient (or surrogate) and physician, that travels with the patient across care settings.
• Code status — Documented patient preferences about resuscitation efforts — typically "Full Code" (all interventions), "DNR" (no CPR but other care continues), "DNI" (no intubation), or "Comfort Care Only.
• Comfort care — A care approach focused entirely on symptom relief and dignity rather than disease treatment.
• Palliative care — Specialty care focused on quality of life and symptom relief for people with serious illness.

Where this comes up in caregiving

More from Kintaria

• Advance directive wizard (51 states) →

See also: all glossary terms · conditions by name · step-by-step playbooks