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Advance Directives

| Date Posted: 1/1/0001

Advance Care Planning Choices: Make them yours, and make them known.

An advance directive gives your family direction on what medical care you want or don't want if you can't communicate. An advance directive gives you the chance to write out your wishes.

The time to think about and communicate your advance care planning wishes is while you and your loved ones are able to discuss your choices – in the comfort of a living room rather than the stress of a hospital.

Why are Advance Directives important to you?

At any age, accidents can happen or health can deteriorate and you can find yourself in a health crisis. The only way to make sure that your health care choices are respected when you are unable to speak for yourself is with legal documents referred to as Advance Directives.

In the event that you cannot speak for yourself, Advance Directives act as a guide for family, friends, and medical staff. They can prevent family arguments, reduce moral distress on loved ones and spare those close to you the anxiety of having to guess what you would have wanted.

What are Advance Directives?

Advance Directives are planning documents that legally ensure your wishes are carried out and prevent courts from obtaining decision-making authority. They allow you to avoid medical treatments you don’t want and to help you articulate what you do want, giving greater peace of mind.

Advance Directives refer to legal documents that specify the kind of medical treatment you want if you are unable to speak for yourself. Some Advance Directives include Living Will and Health Care Power of Attorney.

Living Will also referred to as “Declaration of a Desire for a Natural Death”, details what types of medical treatment you want at the end of life if you are unable to speak for yourself. Before a Living Will can be acted upon, a physician has to determine that you are terminal or in a persistent vegetative state. Typically, this means you have lost the ability to think or reason and will die if the artificial means of keeping you alive is removed.

Health Care Power of Attorney allows you to appoint someone (called a proxy) to make your health care decisions when you can’t communicate for yourself. Your proxy should be someone who knows you well and would be willing to carry out the directions regardless of personal feelings or influence from family and friends. They must be 18 or older. After you select your proxy, discuss your Living Will or health care decisions with them to be sure they clearly understand your wishes and are willing to accept the responsibility. You can appoint a second or third person in case the proxy is unable, unwilling, or unavailable to act for you.

Advance Instruction for Mental Health Treatment is a legal document that tells physicians and mental health providers what mental health treatments you would want and what treatments you would not want if you are unable to decide for yourself.

Facts about Advance Directives

  • Advance Directives DO NOT cost a lot of money to complete. The forms are free and there is no cost to file your Advance Directives with the FirstHealth hospitals. There may be a nominal fee to have the document notarized.
  • Even if you’re not nor have ever been a patient at a FirstHealth hospital, you CAN have your Advance Directives on file for easy access if needed.
  • A Health Care Power of Attorney DOES NOT grant authority over your property or financial affairs.
  • Advance directives DO NOT sign away your right to medical treatment or put you at risk of being denied medical care.
  • Advance Directives SHOULD NOT be kept secret. It is best to discuss your decisions with your family, friends, physicians and clergy. Be sure that copies of the documents are given to the appropriate people and kept on file with your physicians and the hospital.
  • North Carolina Advance Directives ARE NOT always valid in other states. If the NC forms do not meet the requirements of other states, they do not have to respect them and vice versa. If moving to NC, be sure to file new documents that meet North Carolina regulations.
  • After your Advance Directives are on file at the hospital you CANchange them anytime you want by simply sending a letter to the hospital Health Information Management Department or by sending in new documents.
  • Under federal law, medical facilities MUST inform patients upon admission that they have the right to make advance directives and have them respected.
  • Filing your Advance Directives with the state IS NOT required. But if you choose, you can file your paperwork with the state of North Carolina Health Care Registry. More information is available at

Steps to Complete Advance Directive

  1. Use official North Carolina forms or work with your attorney for special instructions. NC forms are available at hospitals, doctor’s offices, churches, or by going online to
  2. Carefully read over the forms. Discuss the issues with family, friends, medical providers, clergy, etc.
  3. Complete the forms to make your personal wishes known.
  4. Sign the forms in front of two witnesses and a notary.
  5. Share your decisions – discuss your decisions especially with your designated Health Care Power of Attorney or proxy.
  6. Provide copies to your doctors, family members, and friends. Place a copy in the glove box of your car. Keep the original in a safe place.
  7. Send a copy to the hospital. Even if you are not a patient, the hospital will create a file for you so that your Advance Directives are readily accessible should the need arise. Please use the following cover sheet when faxing your advance directives to FirstHealth.
  8. Periodically review your Advance Directives and update them as needed. You can revoke old Advance Directives and replace them with a new directive should your decisions change.

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