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Advance Directives

Living wills, DNR orders, and POLST forms, the documents that speak for you when you can't

✓ 8 min read
Updated April 2026
Health & Medical

In this article:

Living Will vs. Healthcare Proxy Understanding DNR Orders POLST Forms Explained Having the Conversation Document Storage Guide
01

Living Will vs. Healthcare Proxy, Both Matter

Most people confuse these two documents, or worse, think they only need one. They serve completely different purposes, and both belong in your file.

Living Will

What it is: A written statement of your wishes about medical treatment if you become unable to communicate. It's a set of instructions, not a person.

When it matters: When you're unconscious, in a coma, or mentally incapacitated, and your written preferences speak for you.

Healthcare Proxy (Healthcare Power of Attorney)

What it is: A designated person who legally makes medical decisions on your behalf. This is a person, not instructions.

When it matters: In situations your living will didn't anticipate, or when real-time judgment calls need to be made. Your proxy fills the gaps.

Here's why you need both: A living will tells doctors "don't resuscitate me if I'm terminally ill," but what if you have a stroke at 45 and survive in a minimally conscious state? Your living will doesn't address that scenario. Your healthcare proxy does, they can say "Let's try therapy for three months, then revisit this."

The living will is your voice in the silence. The healthcare proxy is your advocate in the complexity. Neither one works alone.

Red Flag

Never choose a healthcare proxy who isn't willing to have the hard conversation with you. If they're uncomfortable discussing end-of-life care, they won't be comfortable implementing your wishes when it matters most. Choose someone who listens, not just someone you love.

02

What a DNR Order Means

DNR stands for "Do Not Resuscitate." Most people think this means "do nothing." It means the opposite, it means be very intentional about what you do.

If you don't have a DNR and your heart stops, hospital staff legally must perform CPR. That's broken ribs, chest compressions, intubation, electric shocks, in the hopes of restarting your heart. Sometimes it works. Often it doesn't. When it does, you might wake up severely brain-damaged or in a locked-in state.

A DNR says: "If my heart stops, I don't want CPR to restart it." But, and this is critical, it doesn't mean you get ignored. You still get pain medication. You still get comfort care. You still get dignity.

DNR Myth #1: "DNR means they'll let you die"
False. DNR just means no CPR. You get full treatment for everything else, antibiotics, medication, comfort care. The focus shifts from prolonging life at all costs to extending quality of life.
DNR Myth #2: "DNR is permanent"
False. You can change your mind anytime. If you get a DNR at 75, and at 76 you feel differently, you can rescind it. Medical emergencies aren't locked in.
DNR Myth #3: "The hospital will honor it without a legal document"
False. Verbal agreements don't count in emergencies. You need a signed, state-approved DNR form that gets printed and placed in your medical record before a crisis hits.

The hardest part: DNR conversations usually happen late. You're already sick or aging. But the best time to get a DNR is when you're healthy enough to think clearly about your mortality. Don't wait for the crisis.

03

POLST Forms and When They Apply

POLST stands for "Physician Orders for Life-Sustaining Treatment." It's like a living will's more aggressive cousin, shorter, simpler, and legally binding in a way living wills aren't always guaranteed to be.

Here's the difference:

  • Living will: Instructions to your healthcare proxy and medical team. Guidance-based.
  • POLST: Physician-signed orders that paramedics, EMTs, and hospital staff must follow. Law-based.

A paramedic finding your living will in your glove compartment might not honor it, but they will honor a POLST form. That's because POLST is a medical order, not just a preference.

Who needs a POLST:

You're over 55 and have a serious illness (cancer, heart failure, dementia, COPD)
Your doctor wouldn't be surprised if you died in the next year
You're in hospice or long-term care
You have advanced dementia or frailty
You're having recurring hospitalizations

What POLST covers: Intensity of treatment, CPR preferences, IV fluids, feeding tubes, antibiotics. It's specific, concrete, and actionable.

Pro Tip

POLST forms are printed on brightly colored paper (often bright pink or yellow) and go directly into your medical chart. Ask your doctor if a POLST is right for you, most people who should have one don't.

04

How to Have This Conversation With Your Family

This is the part that terrifies people more than the paperwork itself. You're essentially saying, "I know I'm going to die, and here's what I want." It is a loving thing to do.

When to have it: When you're healthy. Not at Thanksgiving. Not when someone's already in the hospital. Pick a calm moment, a Sunday afternoon, a long drive, after dinner.

Who should be there: Your healthcare proxy, your spouse or partner if applicable, adult children, maybe a trusted friend. Not everyone needs to know every detail, but key people need to know you've thought this through.

How to start: You don't need poetry. You need clarity.

Opening Approaches

You: "I've been thinking about the future, and I want to tell you about some decisions I've made about my medical care. These aren't decisions I'm making right now, but decisions about what I'd want if I couldn't speak for myself."

You: "I need you to know three things: who I want making decisions for me, what kind of medical care I do and don't want, and where I'm keeping these documents. This is a good thing. It's me being clear with you so you never have to guess."

You: "I've filled out some legal paperwork about my healthcare. I want to walk you through it, not because I'm sick, but because I want you to know what I want, and where to find these forms if something happens."

What to cover in the conversation:

Who is your healthcare proxy, and why you chose them
Your wishes about CPR/resuscitation
Your wishes about feeding tubes, ventilators, aggressive treatment
Your wishes about organ donation
Where the documents are stored
Who your doctors are (or where medical records live)
Your wishes about funeral arrangements (optional, but helpful)

What not to do: Don't use euphemisms. Don't say "when I pass away" if you mean "if I'm dying but not yet dead." Say it plainly. Families understand more than we give them credit for.

For Your Healthcare Proxy

Have a separate, private conversation with whoever you've named as your proxy. Let them know what you're asking them to do. Tell them it's okay to be scared or uncertain. But also tell them: "I trust you more than I trust anyone else to speak for me when I can't speak for myself." Most proxies need to hear that.

05

Where to Store These Documents So They Can Be Found

This might be the most important section. A living will stuffed in a safe deposit box is useless. A DNR buried in your filing cabinet is useless. A POLST lost in a drawer is useless. These documents only matter if someone can find them at 2 a.m. when your heart stops.

The rule: Multiple copies, multiple locations, all accessible without a key or a password.

Original signed copies should be:
  • With your healthcare proxy
  • In your doctor's office (ask them to file it in your chart)
  • In your hospital patient record if you have one
  • Accessible at home in a labeled drawer or folder, not locked away
NOT in a safe deposit box
When an emergency hits, hospitals can't access safe deposit boxes at 2 a.m. Bank staff isn't available. You need documents that are reachable in minutes, not hours.
Consider a wallet card
Some states allow wallet cards or medical alert bracelets that say "I have a DNR" or "I have advance directives." Paramedics look for these. It's not a substitute for the real documents, but it's a signpost.

Create a one-page "Emergency Medical Summary" and store it three places:

On your refrigerator, in a red folder labeled "Medical Directives, In Case of Emergency"
In your car glove compartment
With your healthcare proxy, in a folder they can grab

What should be on that one-page summary:

  • Your name, date of birth, and current date
  • Your healthcare proxy's name and phone number
  • Your doctor's name and phone number
  • Your DNR/POLST status (Yes or No)
  • One-sentence statement of your most important wish ("I do not want CPR" or "I want full treatment to the extent possible")
  • Your organ donation status
  • Where full documents are stored
The Refrigerator Hack

Paramedics and hospital staff often look on the refrigerator first. Paramedics learned the habit from years of family emergencies. Put a red folder on your fridge with a label. Inside: your one-page summary, your healthcare proxy's contact info, your doctor's name, and a note saying "Full advance directives stored in [location]." This can shave hours off an emergency.

Update your documents every 3-5 years or after a major life event: New diagnosis, marriage, remarriage, falling out with your proxy, moving to a new state. Medical law changes too. What was true about POLST forms five years ago might be different now.

Tell people where the documents are. Your healthcare proxy should know. A trusted family member should know. Your doctor should know. You don't need to tell everyone, but someone who can act needs to know.

Advance directives are about taking control. They're about saying, "Here's what matters to me, here's how I want to be treated, and here's who I trust to speak for me." That's power. That's clarity. That's love.

These conversations are hard. But they're infinitely harder for your family if you leave them guessing. Have the conversation. Fill out the forms. Store them where they can be found. Then let it go. You've done the hard work.

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The Life Binder

The Life Binder has an Advance directives worksheet: which documents you have, who your healthcare proxy is, your medical preferences written out, and where each person can find them.

The Life Binder covers the household: documents, people, health, money, digital life, and what to do if something happens. Print the whole thing or just the page you need, and fill in what you know. The blanks that are left are your list of what to go find.

Download the Life Binder (PDF)

Paper goes stale, and that is the one problem no binder solves. Hubstone holds the same record and keeps it current, so a changed phone number or a renewed policy updates once instead of in three places.

General information, not legal, medical or financial advice. Requirements differ by state.