What Are End-of-Life and Advance Directive Documents?

Living Wills, Proxies, and Do-Not-Resuscitate Orders

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End-of-life documents, or advance directives, help ensure your healthcare wishes are carried out as you near death and after you die. They are used in circumstances when you are incapacitated, such as in a coma.

Advance directives include proxies, living wills, do-not-resuscitate (DNR) orders, and organ donor cards, all of which are meant to protect you when you can't speak for yourself.

While often thought of something only older adults need to have in place, the COVID-10 pandemic put a spotlight on the importance of these documents for all adults.

This article will walk you through why you need these documents, how they differ by state, and how you can get started on them.

Do not resuscitate order form on clipboard entangled with stethoscope
Peter Dazeley / Getty Images

Documents and Requirements

Legal requirements for end-of-life documents and the names of those documents vary from state to state. Some require notarized signatures. Some require signatures from witnesses who aren't family members.

Both the documentation and the requirements for them are there for your protection. The stricter the regulations, the more difficult it is for someone to go against your wishes.

Those requirements protect the loved one you designate to carry out your wishes—called your proxy. The required signatures give your proxy a clear-cut set of rules. They also keep anyone else from questioning your intent.

Dual Residency

If you live in more than one state (e.g., you winter in Florida and summer in New Jersey), you'll need to have appropriate documents for each location. Be sure to date the documents. Then, if you make changes later, your most current wishes will be enforced.

Different types of advanced directives have different names and purposes. Among the most common are:

  • Durable power of attorney (DPOA): Assigns a person to be your proxy and make medical decisions on your behalf.
  • Living will: Details your wishes for life-extending treatments during terminal illness, such as being put on a feeding tube or respirator, or having your heart re-started.
  • Do-not-resuscitate (DNR) order: A DNR spells out the conditions under which you prefer not to be resuscitated by CPR (cardiopulmonary resuscitation), so if your heart stops, you won't be revived.

Secondary Proxy

In your DPOA document, it's wise to choose a secondary proxy in case your primary proxy dies first or is otherwise unable to speak for you.

Organ Donor Card

Another important end-of-life document is an organ donor card. Your body could provide up to 50 donated organs or tissues, including the:

  • Eyes
  • Heart
  • Liver
  • Stem cells
  • Skin

For some, deciding to be an organ donor is simple. Others find it more difficult for a variety of reasons, including religious beliefs.​

Each state has different laws about how you record your donor status. For example, in some states, it just takes a signature on your driver's license.

Be sure you understand the requirements in your state if you do choose to be a donor.

Getting Started

These resources can help you find documents for getting started on your advance directive(s).

Expressing Your Wishes

End-of-life decisions are difficult ones to face. The four steps below can help you get started.

  1. Ask the right questions and determine your answers.
  2. Record those answers in the appropriate documents.
  3. Discuss your decisions and wishes with family and close friends.
  4. File or store any paperwork or electronic files containing the documents, and distribute copies to the right people.


Advanced directives ensure your wishes are carried out in the event you're incapacitated. They also protect any proxies you may designate to speak for you.

A durable power of attorney, living wills, and do-not-resuscitate are among the more common end-of-life documents.

You may also consider filling out organ donor paperwork.

Laws and procedures for these, and the names of documents, vary by state. Make sure you understand your state's laws regarding them.

A Word From Verywell

You may have a hard time thinking about the circumstances that require these documents. However, it's easier on everyone if you take care of them while you can. Your decisions can ease the burden on your loved ones and help them feel secure that they're acting as you'd want them to.

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Article Sources
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  1. MedicareInteractive.org. Health care proxies.

  2. NOLO. How to write a living will.

  3. National Institutes of Health, U.S. National Library of Medicine: MedlinePlus. Do-not-resuscitate order. Updated July 2, 2021.

  4. Health Resources and Services Administration. Sign up to be an organ donor.