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  • Q |​ How do I document decisions about my future medical care?

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    There are a few ways to document decisions to guide your future medical care:

     

    • Advance Directive (AD) for Healthcare – a legal document with instructions for medical care that only goes into effect if you cannot communicate your own wishes. Usually, an AD is made up of a living will and a healthcare power of attorney.
       

      • A living will is a legal document that tells doctors how you want to be treated if you cannot make your own medical decisions.
         

      • A healthcare power of attorney (HCPOA) is a legal document that names your healthcare proxy or healthcare agent, a person who can make healthcare decisions for you if you are unable to communicate these yourself.
         

    • Provider Orders for Life-Sustaining Treatment (POLST) is a set of medical orders that communicate a person’s wishes for certain end-of-life interventions to healthcare facilities and providers, including emergency medical services. You may also see the terms Medical Orders for Life-Sustaining Treatment (MOLST) or Clinician Orders for Life-Sustaining Treatment (COLST), depending on your state.
       

    • Do Not Resuscitate (DNR) order is a medical order written by a healthcare provider if a person does not want CPR (cardiopulmonary resuscitation) or other lifesaving measures when their heart stops beating.
       

    • Do Not Intubate (DNI) order is a medical order written by a healthcare provider if a person does not want to be placed on a ventilator, or breathing machine, when they are having difficulty breathing.

     

    For more information on each of these types of documentation, see the following pages:

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    Although these documents do not guarantee that your wishes will be followed, they increase the likelihood that the care you receive for a serious illness or injury will be in line with your wishes.

     

    Once you complete your documentation, you can update it at any time. In fact, you should revisit your decisions every so often to make sure they match your current goals and preferences.

  • Q |​ Are there any trans-friendly advance directives?

    Most advance directive forms do not explicitly cover topics related to the care of trans and gender-expansive people. Forms like the Five Wishes→ allow you some flexibility to write in personalized information, like the name you’d like to be called, what matters most to you about your care, and what gender you want recognized in death. The following resources from the Transgender Law Center can help you record your goals and preferences for your care as a trans or gender-expansive person:

     

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    Q |​ Should my advance directive show that I’m trans?

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    You can include a living will in your advance directive that covers trans-specific needs, such as how you want to be dressed and groomed in a hospital, assisted living facility, or funeral home. For more information and for sample language to include in your living will, see the Living Will section of Life Planning Documents for Transgender Communities→ from the Transgender Law Center and the resource Planning for Lifelong Care→.

  • Q |​ Where can I find an advance directive form for my state?

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    You can find an advance directive form that will be recognized in your state at the following locations:

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    You can also search for the form maintained by your state by searching "[insert your state] advance directive form" using a search engine like Google.

  • Q |​ Does an advance directive need to be prepared by a lawyer?

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    Not necessarily. In most cases, you can complete the advance directive form yourself. You will then have to request witness signatures and get the form notarized, depending on your state. You may consult with a lawyer to help you document specific wishes for your care that are not included in the advance directive form itself.

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    There are organizations that provide services to help you complete an advance directive or write a will. Some are free of charge depending on income level, and some charge a fee or refer clients to a list of pro bono lawyers. Search online for free or low-cost estate planning or elder law services in your area.

  • Q |​ How should I store my advance directive?

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    Copies of your advance directive should be stored in secure places that can be accessed easily in an emergency:

     

    • In your wallet, purse, or digitally on your phone

    • With your healthcare proxy

    • With your doctor

    • With a trusted family member or friend

    • In your hospital record

    • In your home where others know where it is

    • In an advance directive registry if your state has one

     

    Note. A safe deposit box is NOT the best place for an advance directive because it will be difficult to access in an emergency.

  • Q |​ Does an advance directive need to be updated?

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    Yes! Advance directives should be reviewed and updated regularly. For example, it could help to update your directive annually on a significant or memorable date to make sure it accurately reflects your goals and preferences for your medical care. To revise your advance directive, you can complete the appropriate form for your state with your updated information. Then obtain the required signatures and have it notarized, as needed. Make sure to replace old versions of your advance directive with the new one, and let your healthcare proxy and your healthcare providers know of the changes.

  • Q |​ What can be done if I am seriously ill and people in my support network do not agree about my care?

     

    Preparing an advance directive can help prevent disagreements about your care during a serious illness. In your advance directive you can document wishes for your care and name someone you trust, called a healthcare proxy, to follow through on them. It is important to keep your advance directive updated and to share any updates to your wishes with your healthcare proxy so they’ll be prepared to help you. You may also document your wishes in a letter of instruction, which is an informal supplement to a will or trust.

     

    Conflicts can still come up. In these cases, your healthcare team may call a family meeting to work through the differences and make decisions that honor your wishes.

     

    Example. A trans woman completes her advance directive before she has any major health issues as she is worried that her biological family will not respect her wishes if she gets sick. She names her nephew, who supported her transition, to be her healthcare proxy because she is confident he will respect her wishes.

Page updated January 2026

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