What this guide is for
Most American adults have not signed an advance directive. The most common reason is not lack of caring; it is that the moment to do it never feels urgent, until suddenly it is. The point of this cluster is to be useful at both moments: the calm evening you finally sit down to fill out your own paperwork, and the harder evening you sit in a hospital waiting room because your parent did not.
Each state page covers the same seven things: what the document is called in that state, who decides if no document exists, where to look for an existing one, the five questions a hospital will ask in the next 72 hours, what to do for yourself tonight, and the official state form plus a short list of resources. The pages cite the relevant state statute and the official state-issued or state-recognized form, because the people reading this in a hospital lounge need a primary source, not a marketing page.
The two parts of an advance directive
Almost every state recognizes two related but distinct documents. Some states allow them to be signed as one combined form; others keep them separate. Either way, completing both is the standard recommendation.
The Health Care Power of Attorney (also called a health care proxy or proxy directive, depending on the state) names a person, your agent, to make medical decisions for you if you cannot. It is broad: surgery consent, facility selection, hospice authorization, decisions about life-sustaining treatment, and access to your medical records. The agent can act in any setting, not only at end of life.
The Living Will (also called an instruction directive in some states) speaks directly to the medical team about life-sustaining treatment if you become terminally ill or permanently unconscious. It is narrower than the Health Care Power of Attorney in scope, but it is the document an ICU physician will reach for when the question is whether to continue a ventilator.
Do this for yourself tonight
If you are reading this because someone else needs an advance directive right now, you will find the right page below. If you are reading this for yourself, the most useful single thing you can do tonight is open your state's page, find the statutory form, and complete it. It takes about twenty minutes. Most state forms require either two adult witnesses or a notary public; some require both. The state page tells you which.
Once it is signed, name your agent out loud. Tell them. Send them a copy. Give a copy to your primary care doctor. The document does not work if no one knows it exists.
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Common questions
What is an advance directive?
An advance directive is a legal document that says who can make medical decisions for you if you cannot make them yourself, and what kinds of life-sustaining treatment you would want or not want. The document only takes effect if a doctor certifies that you have lost the ability to decide for yourself, and it is not the same as a will (which deals with property after death).
What are the two parts of most advance directives?
Most states recognize two pieces. The first is a Health Care Power of Attorney (sometimes called a health care proxy or proxy directive), which names a person, your agent, to make medical decisions for you. The second is a Living Will (sometimes called an instruction directive), which speaks directly to the medical team about life-sustaining treatment if you become terminally ill or permanently unconscious. You can sign one, the other, or both. Most people sign both.
What happens if I never sign anything?
Each state has a default decision-maker hierarchy that kicks in if you have no advance directive and lose capacity. Most state hierarchies start with a court-appointed guardian (if any), then the spouse, then adult children (often by majority), then parents, then siblings, then more distant relatives. Specifics vary by state, which is why this cluster has a per-state page.
Does an advance directive from one state work in another?
Most states honor advance directives validly executed in another state, but the details vary. If you spend significant time in two states (a snowbird, for example, or a parent who lives in one state but receives care in another), the safest approach is to complete a directive that meets the requirements of both states. The state-specific pages in this cluster spell out the rules.
Does Five Wishes count as an advance directive?
Five Wishes (from Aging with Dignity) is recognized as a legal advance directive in most US states. Four states (New Hampshire, Kansas, Ohio, and Texas) require Five Wishes to include a state-statutory-language attachment, which Aging with Dignity ships with the booklet for residents of those states. Wisconsin requires a notice statement. Michigan and North Dakota require a separate agent acceptance form. The remaining states accept Five Wishes as-is.
Do I need a lawyer to complete an advance directive?
Generally, no. Most states publish a statutory advance directive form that any adult can complete without legal help, witnessed or notarized as the statute requires. A lawyer is helpful for people with complicated family situations (estranged adult children, unmarried partners, blended families) or for people who want to combine the advance directive with a broader estate plan.
This cluster is general family information and is not legal advice. State pages cite the statute and link to the official state form so you can verify the rules yourself. For questions about a specific situation, consult a licensed attorney in your state. For editorial standards and corrections policy, see /editorial (link active once that page ships).
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All Family Guides
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