Advance Care Planning: What It Is and How to Start
Advance care planning is a process that helps you document your healthcare preferences for times when you are too sick or injured to speak for yourself. It ensures your wishes are respected and reduces stress for your loved ones during medical crises.
Advance care planning lets you record your healthcare preferences in advance so they are followed if you cannot communicate them later. It is recommended for all adults 18 and older, especially those with chronic health conditions or aging loved ones. Completing legal documents like a living will and healthcare power of attorney is a core part of this process.
Overview
Advance care planning (ACP) is a process for adults of all ages to document their preferences for medical care in case they become too sick, injured, or incapacitated to speak for themselves later. It is not just for elderly people or those with terminal illnesses — unexpected accidents or sudden health events can happen to anyone at any age. ACP typically includes legal documents like a living will, healthcare power of attorney (POA), and do-not-resuscitate (DNR) orders if desired, to ensure your wishes are honored by healthcare providers and loved ones.
Signs It's Time to Start Advance Care Planning
While ACP is beneficial for all adults, certain situations make it especially urgent to complete your plan. If you are facing any of the following scenarios, prioritize starting or updating your advance care plan as soon as possible:
- Recent diagnosis of a serious chronic condition (e.g., heart disease, cancer, diabetes, COPD)
- Age 65 or older
- Preparing for major surgery
- Diagnosed with a cognitive impairment (e.g., Alzheimer's disease, dementia)
- Have strong personal, religious, or cultural beliefs that impact medical care preferences
Causes & Risk Factors for Unmet Care Wishes
The biggest risk factor for not having your healthcare wishes followed if you cannot communicate is failing to document your preferences in advance. Other risks include not discussing your wishes with family and healthcare providers, not designating a trusted healthcare proxy, and not updating your plan after major life or health changes. Without clear documentation, your loved ones may be left guessing your preferences, which can lead to conflict, guilt, or unwanted medical treatments.
Assessing Your Advance Care Planning Needs
There is no medical test to determine if you need ACP, but you can assess your needs by answering a few key questions: Do you have a chronic health condition that may worsen over time? Do you have strong feelings about life support, pain management, or other medical treatments? Do you have a trusted person you want to make healthcare decisions for you if you can't? If you answered yes to any of these, ACP is highly recommended for you.
Treatment & Management: Creating Your Advance Care Plan
The ACP process has three core steps: 1) Reflect on your values and care preferences, 2) Discuss your wishes with loved ones and your healthcare team, 3) Document your preferences in legally valid forms. You do not need a lawyer to complete most advance directives, but forms must meet your state's specific legal requirements to be enforceable.
| Document Name | Purpose | Key Details |
|---|---|---|
| Living Will | States what medical treatments you do or do not want if you are terminally ill or permanently unconscious | Covers preferences for life support, feeding tubes, pain management, and organ donation |
| Healthcare Power of Attorney (POA) | Names a trusted person (your healthcare proxy) to make medical decisions for you if you cannot make them yourself | Your proxy can follow your stated wishes or make decisions in your best interest if your wishes are unclear |
| Do-Not-Resuscitate (DNR) Order | Instructs healthcare providers not to perform CPR if your heart stops or you stop breathing | Only applies if you are in a medical facility, or you can have a portable DNR for use outside a hospital |
Living With Your Advance Care Plan
Once you complete your ACP documents, share copies with your healthcare proxy, family members, and your primary care doctor. Keep a copy in a visible, easy-to-find place at home, and carry a small card in your wallet noting you have advance directives and where they are stored. Review and update your plan every 1-2 years, or after a major health change, marriage, divorce, or if your healthcare proxy is no longer able or willing to serve.
Many people think advance care planning is only for elderly or terminally ill people, but it is recommended for all adults 18 and older. If you are in a serious accident and unable to communicate, your family may not know your wishes, which can lead to conflict or unwanted medical treatments.
- Review your plan annually or after any major life or health change
- Update your documents if your preferences change
- Notify your healthcare proxy and doctor of any updates
- Store copies in multiple accessible locations (home, doctor's office, with your proxy)
Medical Review Team
WellAlly Medical Editorial Team
This content is not a replacement for professional medical advice.
Recovery & management timeline
1-7
Initial Reflection & Preference Setting
Think about your values, goals for medical care, and preferences for treatments like life support, pain management, and feeding tubes. Consider scenarios where you might be unable to communicate your wishes.
1-14
Discussion With Loved Ones & Care Team
Share your preferences with your chosen healthcare proxy, close family members, and your primary care provider. Confirm your proxy agrees to take on the role and understands your wishes.
1-7
Document Your Wishes Legally
Complete state-specific advance directive forms (living will, healthcare power of attorney, DNR order if desired). Ensure forms are signed and witnessed according to your state's legal requirements.
1-3
Share & Store Your Documents
Provide copies of signed documents to your healthcare proxy, family, and doctor. Keep a copy in an easy-to-find place at home, and carry a wallet card noting you have advance directives and their storage location.
Every 1-2 years
Regular Review & Updates
Revisit your advance care plan annually, or after major life changes (e.g., marriage, divorce, new health diagnosis) or if your healthcare proxy is no longer able to serve. Update your documents as needed and notify all relevant parties of changes.
Self-care steps
1Reflect on your care values and preferences
Set aside quiet time to think about what medical treatments you would or would not want in different scenarios, such as if you were in a coma with no chance of recovery, or needed long-term life support. Factor in your personal, religious, and cultural values when making these decisions.
2Choose a trusted healthcare proxy
Select a person you trust completely to make medical decisions for you if you are unable to do so. This should be someone who understands your values and will advocate for your wishes, even if they personally disagree with them.
3Discuss your wishes openly with others
Have honest, clear conversations with your healthcare proxy, family members, and your doctor about your preferences. Clear communication now prevents confusion, conflict, and unwanted treatments later if you cannot speak for yourself.
4Complete legally valid advance directive forms
Use your state's official advance directive forms to document your wishes. You do not need a lawyer to sign these forms, but they must meet your state's signing and witnessing rules to be legally binding.
5Store and share your documents widely
Keep copies of your signed advance directives in multiple accessible locations: with your healthcare proxy, in your medical records at your doctor's office, at home in a visible spot, and carry a small wallet card noting you have advance directives and where they are stored.
When to seek medical help
Seek immediate emergency medical care if you experience life-threatening symptoms including chest pain, difficulty breathing, sudden loss of consciousness, severe bleeding, or sudden weakness/numbness on one side of the body, regardless of your advance care plan status. If you have been diagnosed with a serious or terminal illness and have not yet completed advance care planning, contact your healthcare provider or palliative care team as soon as you are stable to start the process. If you are unable to make your own medical decisions and have no designated healthcare proxy or documented wishes, work with your care team and family to clarify your preferences immediately.
Frequently asked questions
Do I need a lawyer to create an advance care plan?
When should I start advance care planning?
What if my family disagrees with my advance care plan?
Can I change my advance care plan after I complete it?
What is the difference between a living will and a healthcare power of attorney?
Sources
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Medical Editorial Team · Last reviewed October 9, 2026. · Read our editorial policy