Advance Directive: Living Wills, Proxies, and DNRs

An advance directive puts your health care wishes in writing so they are followed if you cannot speak for yourself. It is an umbrella term: a complete directive usually combines a living will, which records your treatment wishes, with a health care power of attorney, which names someone to decide for you.

By Settled Estate Editorial Team

Published: July 16, 2026Updated: July 16, 2026

The Short Answer

People use several names for these documents, and they overlap, which is where the confusion starts. “Advance directive” is the broad category. A living will and a health care power of attorney (also called a health care proxy) are the two documents inside it. A DNR is a separate medical order a doctor signs.

The health care power of attorney is a cousin of the financial power of attorney, but for medical decisions rather than money. Together these documents are a central part of a complete estate plan.

The Documents Compared

Document	What it does	Who creates it
Advance directive	Umbrella term for the documents that state your health care wishes	You
Living will	States which treatments you want or refuse if terminally ill or permanently unconscious	You
Health care power of attorney (proxy)	Names a person to make medical decisions when you cannot	You
DNR (do not resuscitate)	A medical order not to perform CPR if your heart or breathing stops	A doctor, at your request
POLST	A medical order for the seriously ill covering CPR and other treatments	A doctor, with you

The documents you write (living will, health care power of attorney) express wishes. The medical orders a doctor signs (DNR, POLST) carry those wishes out at the bedside.

What Each One Does

Living will. Your written instructions about treatments such as life support, tube feeding, and resuscitation, for situations where you are near the end of life and cannot speak. It guides your doctors and your agent.
Health care power of attorney. Names a trusted person (your agent, proxy, or surrogate) to make medical decisions for you when you cannot, including situations your living will does not spell out. This is the single most useful piece, because no document can predict every scenario.
DNR order. A physician order in your chart directing staff not to attempt CPR. It is narrower than a living will and applies right now, not just at the end of life.
POLST. A portable medical order for people who are seriously ill or frail, covering CPR plus choices about hospitalization and other treatment. It travels with the patient between care settings.

How to Make One

The steps are similar across states, though the form and the signing rules differ:

Decide your wishes, and choose a health care agent and a backup who will honor them.
Complete your state’s advance-directive form, which combines a living will and a health care power of attorney.
Sign it the way your state requires, usually before two witnesses, a notary, or both.
Give copies to your agent, your doctor, and close family, and keep the original where it can be found.

Most states offer a free statutory form, and many online estate-planning services include an advance directive alongside a will and financial power of attorney.

Your State Advance-Directive Guide

The exact form, the terms your state uses (living will, health care proxy, or combined directive), and the signing rules vary. Open your state’s guide for the local specifics:

Frequently Asked Questions

What is the difference between a living will and an advance directive?

An advance directive is the umbrella term for the documents that record your health care wishes, and a living will is one of them. The living will states which treatments you would or would not want if you were terminally ill or permanently unconscious. Most complete advance directives pair a living will with a health care power of attorney, which names a person to make decisions the living will does not cover.

What is the difference between an advance directive and a DNR?

You write an advance directive yourself, while a DNR (do not resuscitate) order is signed by a doctor and placed in your medical record. An advance directive covers your broad wishes across many situations; a DNR is a specific medical order telling staff not to perform CPR if your heart or breathing stops. You can have both, and a DNR generally carries out a wish expressed in your directive.

Do I need a lawyer to make an advance directive?

Usually not. Most states publish a free statutory advance-directive form, and many hospitals and online services provide one. A lawyer is helpful when your wishes are complex, when you want the directive to fit alongside a will or trust, or when family disagreement is likely. Whatever the source, the document has to be signed and witnessed or notarized the way your state requires.

Does an advance directive expire?

No. An advance directive stays valid until you revoke it or replace it with a new one, which you can do at any time while you have capacity. It is still worth reviewing it every few years and after major life events, because your wishes and the people you would name can change. Give copies to your health care agent, your doctor, and your family.

What happens if I do not have an advance directive?

If you cannot make your own decisions and left no directive, your state’s health care surrogate law decides who chooses for you, usually a spouse, then adult children, then other close relatives, in a set order. That person may not know your wishes, and if no one is available or family disagrees, a court may have to appoint a guardian. An advance directive keeps that choice with you.

Information current as of July 16, 2026

Settled Estate is not a law firm, and this content is for informational purposes only and does not constitute legal advice. Probate laws and procedures in your state can change. Consult with a qualified attorney for advice specific to your situation. Full disclaimer.