Advance care planning
Your healthcare is just that: yours. That means your healthcare team needs to know your personal priorities. We’re here to support and guide you and your family as you make decisions about your future healthcare needs.
What’s an advance directive?
An advance directive is a legal document that provides guidance to your healthcare team and loved ones on the types of care you want or don’t want to receive. Advance directives are also used to appoint someone you trust to make medical decisions on your behalf if you can’t communicate your wishes yourself.
You can create an advance directive at any time. With advance directives, you can:
- Document your priorities and preferences for medical care.
- Designate your healthcare preferences in advance so your loved ones don’t have to make difficult decisions on your behalf.
- Designate someone to make decisions for you if you become unable to.
- Have a sense of control over some of life’s most important decisions.
Types of advance directives and medical orders in Pennsylvania
Durable healthcare power of attorney (POA)
A medical or healthcare power of attorney allows you to name a person to make healthcare decisions for you when you’re unable to make them for yourself. It can also be called a durable power of attorney for healthcare or a healthcare proxy.
The person you choose might be your spouse, an adult child, another family member or a friend. You may also choose one or more alternates in case your first choice is unable to fulfill their role. Choose someone who:
- Meets your state's requirements for a healthcare agent
- Is not your doctor or a part of your medical care team
- Is willing and able to discuss medical care and end-of-life issues with you
- Can be trusted to make decisions that support your wishes and values
- Can be trusted to be your advocate if there are disagreements about your care
This legal document* names someone you trust who can help make decisions about your care if you’re unable. You may also choose to add specific guidance about your healthcare priorities.
Living will
A living will is a legal document that details your decisions on issues such as pain management and organ donation. It also includes medical treatments you would or would not want doctors to use to keep you alive if you're diagnosed with a terminal illness or are in a permanently unconscious state.
When creating your living will, consider your values, the quality of life versus length of life, and the circumstances under which you would or would not want your life prolonged. Talk with your primary care doctor, healthcare agent, family and friends about your personal wishes for:
- Resuscitation
- Mechanical ventilation
- Tube feeding
- Use of dialysis, antibiotics or antivirals to treat end-of-life infections
- Comfort care (palliative care) to manage pain
- Organ and tissue donation
- Donating your body for scientific study
This legal document* outlines the types of care and treatment you do and don’t want, such as resuscitation or the use of a feeding tube if you’re either permanently unconscious or in an end-state condition as determined by your physician. Some documents may allow you to designate someone to make treatment decisions on your behalf.
Pennsylvania Orders for Life-Sustaining Treatment (POLST)
A POLST is a medical order — signed by a clinician — that documents end-of-life decisions made collaboratively by you and your healthcare providers. Unlike a living will, which you can complete on your own at any time, a POLST can only be created after a discussion with your healthcare team.
A POLST is designed to be portable, meaning it applies whether you receive care at home, at a nursing facility or in a hospital. It is especially suited to those with a limited life expectancy — typically 1 year or less — who want to make sure their preferences are known to any provider or emergency responder who treats them.
*Advance directives, such as living wills, appointing a healthcare proxy or power of attorney, are written documents that tell others what your personal, spiritual, medical and legal wishes are should you become seriously ill, or are unable to make decisions on your health. This could be when you are undergoing surgery, have an accident that leaves you temporarily incapacitated or are considering end-of-life care. Having an advance directive lets your medical team and caregiver know exactly what you want when you are seriously ill. It also allows you to appoint another individual to make decisions about your healthcare if you are unable to make them for yourself.
Geisinger encourages patients to have an advance directive in their electronic medical record. These documents, which are written and signed while you are still fully able to express and articulate your wishes, allow you to plan your care if you are temporarily or permanently unable to make decisions.
The forms contained on this page are not intended to constitute legal advice, rather, the information and materials are available for general informational purposes only. Individuals should contact their attorney to obtain advice with respect to any particular legal matter.