Advance Directives in Illinois: A 72-Hour Guide for Families

If you are reading this, your mom or dad is probably in a hospital bed in Chicago or Aurora or Naperville, and a social worker has just used a phrase you have not heard before. Power of attorney for health care. Living will. Surrogate. Code status. The doctors need an answer in the next day or two, and the answer depends on a piece of paper that may or may not exist.

This page is the one you wish you had found first. It tells you what the document is called in Illinois, who is allowed to decide if there is no document, where to look for one, and what the next 72 hours are likely to ask of you. It is written for the family on the elevator going up to the ICU, not for the lawyer in the office.

Illinois recognizes several different documents that together cover advance care planning. The most common, and the one most Illinois adults sign, is the Power of Attorney for Health Care, governed by 755 ILCS 45 Article IV. This document names a person, called the agent, to make medical decisions when your parent cannot. The agent can consent to surgery, agree to or refuse a feeding tube, choose a nursing home, authorize hospice, and decide about life-sustaining treatment.

Illinois also recognizes a separate Living Will Declaration (755 ILCS 35), which directs the medical team about life-sustaining treatment in terminal conditions, plus a Mental Health Treatment Preference Declaration and a POLST (Practitioner Orders for Life-Sustaining Treatment) form. Most Illinois adults focus on the Power of Attorney for Health Care because it is the broadest of the four.

Five Wishes, the popular nationally-distributed booklet from Aging with Dignity, substantially meets Illinois requirements and is honored as a valid advance directive. No state-statutory-language attachment, notice statement, or extra acceptance form is required. The booklet must be signed under Illinois witness rules.

If your parent never signed a Power of Attorney for Health Care and never signed a Living Will, the hospital does not get to pick a decision-maker, and you do not either. Illinois statute does. The relevant law is the Illinois Health Care Surrogate Act (755 ILCS 40), specifically 755 ILCS 40/25.

The priority order is:

1. The patient's guardian.
2. The spouse or partner of a registered civil union.
3. An adult son or daughter.
4. Either parent.
5. An adult brother or sister.
6. An adult grandchild.
7. A close friend of the patient.
8. The guardian of the estate.

Two practical points. First, when more than one surrogate at the same priority level is reasonably available (for example, several adult children), the statute requires reasonable efforts to reach consensus, with a majority controlling if no consensus is possible. Second, Illinois explicitly includes "close friend" in tier 7, which is more flexible than many states and can include long-term partners or close family friends who know the patient well.

Most Illinois adults who completed an advance directive have a copy in one of five places. Check them in this order, because the easiest ones are also the most likely.

1. The hospital admissions packet. Illinois law requires hospitals to ask about advance directives on admission and to provide the Statement of Illinois Law. If your parent has been admitted to this hospital before, the directive may already be scanned into the electronic medical record.
2. The primary care doctor's chart. Most IL primary care offices keep a copy. Call the office and ask them to fax or send a copy to the hospital.
3. A home filing cabinet or desk drawer. Most people store the signed original with their will, their birth certificate, and their Social Security card.
4. A safe-deposit box. Common but inconvenient in an emergency, because the bank may require a court order to open the box without the named holder.
5. The estate-planning attorney's file. If your parent worked with an attorney on a will or trust, that attorney almost certainly has a copy of the advance directive on file.

In a typical Illinois hospital admission for an older adult, five questions tend to land on the family within the first three days. Knowing they are coming makes it easier to face them.

Code status.Does your parent want CPR if their heart stops? IL hospitals will ask this on admission, and the default is full code (everything done). Illinois has a POLST form (Practitioner Orders for Life-Sustaining Treatment) that translates a patient's wishes into actionable medical orders signed by a physician; ask whether one is on file.

Feeding tube. If your parent cannot swallow safely after a stroke or a serious illness, the team may ask about a feeding tube. The Illinois Living Will form addresses nutrition and hydration, and the Health Care Surrogate Act has specific procedures for surrogate consent to withdraw artificial nutrition.

Hospitalization versus hospice.If the underlying illness is terminal, the question may be whether to keep treating in the hospital or move to hospice. Hospice care can happen at home, in a nursing facility, or in a free-standing hospice house. Your parent's wishes drive this choice.

Who is the agent or surrogate. If there is a Power of Attorney for Health Care, confirm the named agent is on file and reachable. If not, the hospital will walk through the Health Care Surrogate Act hierarchy and identify the highest-priority surrogate available.

Discharge plan. Once your parent is medically stable, the question becomes where to go next. Home, with home health. A skilled nursing facility for short-term rehab. A long-term care facility. Hospice. The advance directive informs this conversation but does not decide it; that is what the discharge planner is for. Search Illinois facilities to compare options.

Sitting in a hospital waiting room is a strange place to think about your own mortality. It is also the most clarifying. Most people who watch a parent go through this resolve, sometimes inside the first day, that they will not put their own children through the same ambiguity. The way to keep that resolution is to act on it before the feeling fades.

Tonight or tomorrow, complete your own Power of Attorney for Health Care. The Illinois Department on Aging publishes the statutory short form, accepted at every IL hospital. It takes about twenty minutes. The form walks you through naming an agent, choosing an alternate, and (optionally) writing in your specific wishes about life-sustaining treatment.

Once it is signed, name your agent out loud. Tell them. Send them a copy. Send a copy to your primary care doctor. Tape one to the inside of a kitchen cabinet where someone will find it if they need it. The document does not work if no one knows it exists.

• Illinois Department on Aging: Legal Forms (Advance Directives) The official statutory short form for the Power of Attorney for Health Care plus the Statement of Illinois Law on Advance Directives.
• 755 ILCS 45 Article IV: Powers of Attorney for Health Care The full Illinois Power of Attorney for Health Care statute.
• 755 ILCS 40: Health Care Surrogate Act The full surrogate decision-maker statute, including the priority order at 755 ILCS 40/25.
• Illinois Long-Term Care Ombudsman Program Free advocacy if you have a complaint or concern about a nursing facility, assisted living, or home care provider in Illinois.
• Illinois State Bar Association: Lawyer Finder If your situation needs a lawyer, this is the official referral path.