Every year, National Healthcare Decisions Day comes around as a reminder—a reminder that planning ahead doesn’t just matter, it can spare families an incredible amount of confusion and heartache when health crises strike. Many people avoid talking about advance directives because they find it uncomfortable or believe it’s something only the elderly need. But the reality is, no one knows what tomorrow brings. I’ve sat across from patients of all ages and backgrounds, and I can assure you: if you’re over 18, there are two crucial documents everyone should have on file. Let me explain why these documents—the healthcare proxy and the living will—are so essential, and what they actually mean for you and your loved ones.

Most of us expect that, when the time comes, we’ll get to weigh in on decisions about our own medical care. But life doesn’t always give advance warning. Medical emergencies can leave you unable to speak for yourself, even temporarily. In these high-stress moments, your loved ones and healthcare team need clear guidance. Without it, confusion can set in, sometimes leading to decisions that might not align with your wishes. That’s where these two documents step in—they give you a voice, even when you can’t speak up.

Why Advance Directives Matter for Everyone

As a physician, I’ve seen firsthand how having advance directives in place brings clarity and comfort to families under stress. Advance directives are legal documents that spell out your preferences for medical care if you’re unable to communicate. They ensure your values and wishes are respected, and they prevent loved ones from being left with heartbreaking guesswork or disagreements.

A common misconception is that advance directives are just for people with serious illness or for older adults. In reality, accidents and sudden illnesses can strike anyone. The National Institute on Aging notes that advance care planning improves the chances you’ll receive the care you want, even if you can’t communicate (NIA). Having these documents ready doesn’t mean you expect the worst—it means you care enough about your future and your loved ones to plan ahead.

Let me share a scenario I see too often: A young adult is involved in a car accident and winds up unconscious in the hospital. Treatment decisions need to be made—sometimes quickly. Without a healthcare proxy or living will, doctors and family members scramble. Sometimes, not everyone agrees on the best course of action. Your voice, your wishes, might go unheard in the chaos. Advance directives spare your loved ones from having to make impossible choices without your input.

The Two Essential Documents: Healthcare Proxy and Living Will

Advance directives include several possible forms, but the two everyone should consider are the healthcare proxy (also called a medical power of attorney or durable power of attorney for healthcare) and the living will. Here’s what each does—and why having both makes all the difference.

What Is a Healthcare Proxy?

A healthcare proxy is a legal document where you appoint someone you trust—often called an agent or surrogate—to make medical decisions for you if you lose the ability to speak for yourself. This person only steps in if you’re unable to make your own decisions. Think about it like naming a backup quarterback: you want someone who knows your values and will honor the choices you’d make.

This agent can ask questions, talk with doctors, understand your medical situation, and accept or refuse treatments on your behalf. They must act according to your wishes and your best interests. If your health changes suddenly—such as during an accident or stroke—the healthcare proxy “activates” and your agent steps in while you recover or until you can communicate again.

The best person for this job is someone calm under pressure, who will advocate for what you truly want. It might be a spouse, child, parent, or trusted friend. You don’t have to pick a family member. The most important thing is that you talk clearly with your agent about your preferences. Don’t assume they automatically know. Give them the guidance they need, so when the time comes, they’re not left guessing.

One critical point: Without a healthcare proxy, your medical team will often turn to your closest relative—but what if family members disagree? Or what if that person isn’t comfortable making big medical decisions? By naming a healthcare proxy in writing, you make sure your wishes are clear, and an advocate of your choosing is officially in place.

What Is a Living Will?

A living will is different from a will that describes what happens to your belongings after you die. A living will tells doctors and your healthcare agent what kinds of medical treatments you would—or would not—want if you’re seriously ill, permanently unconscious, or at the end of life and cannot speak for yourself. This is your chance to be clear about things like:

• Whether you would want to be on a ventilator if you couldn’t breathe on your own
• If you want feeding tubes or artificial nutrition if you’re unable to eat
• Your wishes about CPR (cardiopulmonary resuscitation)
• Your thoughts on pain management, comfort care, and organ donation

The living will is a set of instructions, not a script. You’re not predicting every possible scenario; you’re sharing your values and wishes so loved ones and doctors aren’t left in the dark. The CDC reports that just over 1 in 3 adults have completed some form of advance directive (CDC), which means most people haven’t made their preferences clear—leaving a heavy burden for others in a crisis.

Your living will might state, “If I’m in a permanent coma, I would not want feeding tubes or artificial breathing,” or “If there’s any chance for meaningful recovery, I want every measure taken.” These are deeply personal choices. Writing them down and sharing them with your proxy, your doctor, and close family helps ensure you get the care you want, not just what is available.

How Do These Documents Work Together?

Sometimes patients ask me, “If I write down my wishes, do I still need a healthcare proxy?” The answer is yes. The living will gives general directions, but only a real person—a healthcare proxy—can handle complicated, unexpected situations and talk directly with the medical team. For example, there may be new treatments, changes in your medical status, or a scenario your living will doesn’t directly address. Your proxy can speak for you, using your living will and their knowledge of your values as a guide.

Think of your living will as the playbook, and your healthcare proxy as the coach on the field. Both are essential. If you only have one, important pieces can be missing. Together, these tools make sure you remain the decision maker—no matter what comes your way.

Faith, Family, and Misconceptions: Addressing Common Questions

1. “Aren’t these documents just for the elderly or sick?”

This is a myth. Car accidents, strokes, sudden illnesses—they can happen to healthy people of any age. The truth is, anyone over 18 should have these documents. Advance care planning is a way of protecting yourself and those you care about, regardless of your age or health status.

2. “If I complete advance directives, am I giving up on care?”

Absolutely not. Advance directives are about having a say in the care you receive, not about limiting care. You can state in your documents that you want all life-saving measures—or that you’d prefer comfort-focused care. Plenty of healthy people choose to say, “Do everything you can to help me recover.” These forms are simply a way to record your preferences, whatever they may be.

3. “What if my faith influences my decisions?”

Your advance directives are meant to reflect your personal values, including your religious or cultural beliefs. It’s helpful to talk with your faith advisor or family as you consider these forms. Many hospitals and clinics have chaplains or social workers who can walk through the options and help make sure your wishes are respected.

4. “Can I update my documents if my wishes change?”

Yes. You can revise or revoke your advance directives at any time. It’s a good idea to review them every couple of years, or after major life events (like marriage, a new diagnosis, or a significant change in health). Make sure to give updated copies to your proxy and doctor.

How to Complete Advance Directives: A Step-by-Step Guide

This is where it gets practical. Filling out a healthcare proxy and living will may sound complicated, but it’s actually fairly straightforward. Every state has its own forms and requirements, which are usually available through your state health department, hospital, or even online via reputable sources like the National Healthcare Decisions Day website.

• Step 1: Download your state’s forms for healthcare proxy and living will. (Some states combine these into one advance directive.)
• Step 2: Choose your healthcare proxy thoughtfully and talk with them about your wishes. Share your values, what quality of life means to you, and any “hard lines” you have.
• Step 3: Complete the forms, stating your wishes as clearly as possible. If you need help, social workers, palliative care teams, and even some attorneys can assist.
• Step 4: Sign the forms. Most states require witnesses or a notary. Follow your state’s instructions exactly for the documents to be valid.
• Step 5: Distribute the documents. Give copies to your proxy, your primary doctor, and close family or friends involved in your care. Keep a set in an easily accessible place (not locked in a safety deposit box).
• Step 6: Revisit them periodically, especially after health changes or major life events.

Clinical Scenario: Advance Directives In Real Life

Let me give you a real-world example drawn from my experience. A middle-aged patient—let’s call her Maria—came to the hospital after a severe stroke. She hadn’t completed any advance directives. Her adult children were suddenly thrust into the position of making decisions for her, but they had very different views and remembered previous conversations in conflicting ways. One wanted aggressive treatments no matter what, while the other worried about prolonging suffering. Without clear documentation, the medical team spent days just facilitating discussions. Emotions ran high. The family struggled, and Maria’s wishes never became truly clear.

I contrast this with another patient, who had completed both a healthcare proxy and a living will. When she was unable to communicate, her proxy knew exactly what she wanted regarding life support and comfort care. The hospital followed her documented wishes, and her family could focus on being there for her instead of arguing over treatment decisions. Advance directives spared them added stress at an already difficult time.

Frequently Asked Questions About Healthcare Decisions Day

Q: Are these documents the same everywhere in the U.S.?

A: Every state has its own forms and rules for advance directives, and some have different terminology. However, the basic principles—a designated agent and written instructions—apply everywhere. Most healthcare providers can help you find your state’s approved forms.

Q: Does having advance directives mean I won’t get aggressive treatment if it’s needed?

A: Not unless that’s what you specify. You remain in control. Some people use advance directives to request aggressive care until recovery is impossible, while others limit certain interventions. It’s all about personal choice.

Q: My family knows my wishes. Why do I still need these documents?

A: Verbal instructions can get forgotten, misinterpreted, or ignored in a stressful situation, and family members may not all remember things the same way. Written documents provide clarity, avoid misunderstandings, and carry legal authority recognized by hospitals.

Key Takeaways and Next Steps

If you’ve never completed a healthcare proxy or living will, don’t wait for a crisis. National Healthcare Decisions Day is the perfect time to take action. Having these two documents isn’t just a box to check—they are gifts to yourself and to your loved ones, easing decisions and uncertainty when life takes an unexpected turn.

I encourage you to talk openly—with your doctor, your proxy, and your family—about your values and healthcare preferences. Remember, you can always change your mind and update your documents. But the important thing is to start. Advance care planning isn’t about loss or fear. It’s about empowerment, dignity, and peace of mind.

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And as always, if you have questions about your unique situation or state-specific rules, talk with your healthcare provider or a trusted legal adviser. Your future self—and your family—will thank you.