Living Will and Advance Directives: A Practical Checklist for Older Adults

Living Will and Advance Directives: Practical Steps (Not Legal Advice)

Key takeaways

• Advance directives are legal documents with instructions for medical care that apply only if you cannot communicate your wishes.[1]
• The two most common health-care advance directives are a living will (what treatments you want or want to avoid) and a durable power of attorney for health care (who your health care proxy is).[1]
• NIA says the most important part is meaningful conversation with people you trust—not only paperwork.[1]
• Treat directives as living documents: review at least once a year and after major life changes (retirement, move out of state, big health change).[1]
• This page is not a do-it-yourself statute kit. For financial POA and estate overview, see Power of attorney and advance directives. For a short durable POA starter (finances + health care), see Durable power of attorney.

Living will vs. health care proxy vs. last will

You can choose a proxy in addition to or instead of a living will.[1]

NIA notes an advance directive is legally recognized but not legally binding in every situation—clinicians and your proxy do their best, but complex cases can be unclear. That is why conversations matter.[1]

If you have no advance directive

NIA explains that state law decides who may decide for you—often a spouse, parents, or adult children. An unmarried partner who is not named as proxy might be left out. Some states allow a close friend; some assign a physician. Check your state legal aid office or state bar association for local rules.[1]

NIA’s get-started steps

1. Reflect on values and what matters most at the end of life.[1]
2. Talk with your doctor. Advance care planning discussion is covered by Medicare as part of your Annual Wellness Visit.[1]
3. Choose a proxy you trust; discuss your values even if you are not ready for every treatment detail.[1]
4. Complete forms—living will and/or durable power of attorney for health care.[1]
5. Share copies with your proxy, clinicians, and lawyer; store originals safely. Some states offer registries.[1]
6. Keep talking and update at least yearly or after major changes; note dates when older copies are replaced.[1]

How to find forms (often free)

NIA lists low- or no-cost paths:[1]

• Your State Attorney General’s office
• Local Area Agency on Aging via the Eldercare Locator (800-677-1116) or eldercare.acl.gov
• Free state forms linked from national groups such as AARP, the American Bar Association, or the National Hospice and Palliative Care Organization
• Veterans: ask your local VA about a VA advance directive

If you spend a lot of time in more than one state, NIA suggests considering forms for each state and keeping copies in each place.[1]

A lawyer is not always required to create advance directives, but NIA says giving a copy to your lawyer is wise if you have one. Paid online form sites exist; NIA reminds readers that free options often exist first.[1]

Other orders clinicians may discuss

NIA also describes hospital/facility orders that are different from a living will alone—for example DNR, DNI, DNH, out-of-hospital DNR, and POLST/MOLST (portable medical orders often used when you are near the end of life or critically ill). Availability and names vary by state; ask your clinician or state health department.[1]

Practical checklist (original)

• I can say in one sentence what “a good day” means to me
• I have named a proxy and at least one backup
• My proxy has agreed out loud and has a copy
• My primary doctor has a copy
• Wallet or phone note lists proxy name and phone
• Calendar reminder to review each year
• Financial POA discussed separately with counsel — see POA overview

FAQ

Is a living will the same as a will?
No. A living will guides medical care while you are alive but cannot speak. A last will deals with your estate after death.[1]

Do I need both a living will and a proxy?
NIA says a proxy can be chosen in addition to or instead of a living will; many people do both so instructions and a decision-maker are clear.[1]

Will doctors always follow my form?
They do their best. NIA says providers may refuse if a decision goes against conscience, facility policy, or accepted standards—and must then tell your proxy and consider transfer.[1]

Where does Medicare fit?
You can discuss advance care planning during the yearly Wellness visit.[1]

• Related: Power of attorney and advance directives
• Related: Medicare Annual Wellness Visit
• Related: What to do when someone dies
• Related: Grief support
• Related: Caregiver burnout and support

Sources

1. National Institute on Aging. Advance Care Planning: Advance Directives for Health Care. NIH/NIA. https://www.nia.nih.gov/health/advance-care-planning/advance-care-planning-advance-directives-health-care. Accessed October 30, 2026. (Full HTML opened HTTP 200.)

Disclaimer

This article is for general education only and is not legal, medical, tax, or financial advice. Advance-directive rules and form requirements are state-specific. Do not rely on this page for forms or filing steps. Consult a licensed attorney in your state and talk with your clinician about care preferences. In an emergency, call 911.

Attribution

Portions of this page are adapted from "HowToLiveBetter" (高性价比人生指南) by eternity4719, https://github.com/eternity4719/HowToLiveBetter, licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Changes: topic idea adapted from Chapter 17 themes; rewritten for the U.S. context from NIA advance care planning guidance (not a direct translation). China-specific formalities were not used.