Quick Guide to the Advance Directive

  1. This form helps your doctor and family know the kind of care you want at the end of life, including the use of a ventilator, IV fluids, and feeding tube.
  2. This form is NOT used in an emergency (cardiac arrest). There are other forms for that (DNR, POLST– see the opposite side).
  3. You can change your mind at any time. Doctors will ONLY rely on this form if you cannot answer for yourself.
  4. You don’t need a lawyer or notary public to complete this form.You need the signature of two witnesses who will confirm that these are your wishes.
  5. In truth, this form is rarely necessary unless you have a serious stroke, brain damage, or dementia. But it begins an important conversation.
  6. Please make copies for your family, your doctor, and the institution where you live (if this applies). More importantly, talk to them about your wishes.
  7. This form allows you to name an agent (healthcare power of attorney) to speak on your behalf.
  8. It allows you to name your primary care physician.
  9. It allows you to name yourself as an organ donor.
  10. Ask your primary care doctor for an Advance Directive, or order it on-line through maine.gov, AARP, or Maine Hospital Association websites.