Advance Directives: Making your wishes known

When loved ones are seriously ill or injured in an accident and unable to communicate their wishes, the pressure is on families to make life-or-death decisions about extreme treatment measures.

Advance directives allow you to convey your end-of-life wishes if you are unable to communicate.

Advance directives are legal documents that allow you to spell out your decisions about end-of-life care ahead of time. They give you a way to tell your wishes to family, friends, and health care professionals and to avoid confusion later on.

A Living Will allows you to document your wishes concerning medical treatments at the end of life. It specifies which treatments you want to sustain life if you are dying or permanently unconscious. It instructs your family and medical team about treatments you want to accept and refuse. Decisions may relate to:

  • Dialysis
  • Ventilator use
  • CPR
  • Tube feeding
  • IV hydration
  • Comfort care
  • Organ or tissue donation

Health Care Proxy (also known as a health care power of attorney) allows you to appoint a person you trust as your health care agent, who is authorized to make medical decisions on your behalf. A durable power of attorney for health care is a document that names your health care proxy.

Your proxy should be familiar with your values and wishes. They should be trusted to support your decisions as outlined in your living will. Some people are afraid that rejecting specific treatments with a living will is what they want in one instance but not another. A named health care proxy can evaluate each situation or treatment option independently.

A Do Not Resuscitate Order, or DNR is a physician’s order that directs health care professionals and emergency medical personnel NOT to perform cardiopulmonary resuscitation if your heart or breathing stops. Your New York documents will not be effective in the event of a medical emergency. Ambulance personnel are required to provide cardiopulmonary resuscitation (CPR) unless they are given a separate DNR order that states otherwise. A DNR is only completed when someone is chronically or seriously ill.

An Organ Donor Designation allows you to document your wishes regarding donating your organs after your death. Even if you have indicated that you would like to be an organ donor, your family or health care proxy/agent must give their permission for organ donation, so make sure they know your wishes to take place.

How do I create advance directives?

You can prepare your own advance directives. Most people do not need an attorney to prepare advance directives paperwork. Forms are available through the state and the United Hospice at the links listed above.

When you are ready to create your advance directives, you should:

  • Prepare your advance directives to reflect your decisions.
  • Read instructions carefully to ensure that you have included all necessary information.
  • Have your documents witnessed.
  • Use your state-specific advance directives.
  • Include requests concerning hospice care, organ donation, cremation, or burial.
  • Make your physician and loved ones aware of your specific requests so appropriate referrals and arrangements can be made.

When does my proxy take over my health care decisions?

Before a medical power of attorney goes into effect, a person’s physician must conclude that a person is unable to make their own medical decisions. If a person regains the ability to make decisions, the health care proxy no longer acts on the person’s behalf.

Making your wishes known

After completing your advance directives, you need to talk to your family, your healthcare team and friends about your wishes. It’s important to keep the originals in a secure but accessible place. Give copies to your agent, family members, doctor, or anyone who may be involved in your health care decisions.

  • If you enter a nursing home or hospital, have photocopies of your documents placed in your medical records.
  • Discuss your wishes with your proxy and doctor often, especially if your medical condition changes.
  • If you want to make changes to your documents after they have been signed and witnessed, you must complete new documents.
  • Update your documents if you have an important change in your life or health, such as a new diagnosis or a change in marital status.
  • You can always revoke one or both of your New York documents.
  • Review advance directives at least once every ten years to make sure your choices are still in line with your values and wishes.

United Hospice, Inc., has developed the perfect solution for you. It is a free, secure, web (internet) based site that enables your documents to be safely stored and accessed by health professionals when they are needed. It is called Print a copy of the enrollment form and sign it. Mail the enrollment form with copies (NOT the originals) of your advance directives to:
c/o United Hospice
New City, NY 10956

We will scan and upload the documents to the website and mail back your documents along with three ID cards that include your name and password. One card is designed for you to carry in your wallet, one is for your health care agent and one is for your physician. Instructions to retrieve your directives are on the back of the card. You can request additional wallet cards by calling us at 845.634.4974.

If you have questions or would like more information about advance directives, contact United Hospice at 845.634.4974 or