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Health care directive forms

Allina Health patients in Minnesota and Wisconsin can use these forms to provide their families and health care team members written instructions about their wishes.

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Helpful tips

  • A member of your health care team -- such as a social worker, chaplain, home health or palliative care nurse -- can help you prepare a health care directive.
  • You do not always need a lawyer to prepare a health care directive.
  • Laws about advance directives are not the same in all 50 U.S. states. If you spend a lot of time in another state, or if you move to another state, be sure you understand the laws in each state.
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Be prepared to make your health care wishes known

Health care directives

A health care directive (formerly called a living will) gives your family direction on what medical care you want or don't want if you can't communicate. This document gives you the chance to write out your wishes.

It is suggested that all people, even those not currently ill or having surgery, make sure their loved ones are aware of their wishes. A health care directive is a way to do that.

For help completing a health care directive or to set up a meeting with an advance care planning facilitator, call 612-262-2224 or
1-855-839-0005.

The health care directive goes into effect if you cannot make medical decisions or make your wishes known (such as you cannot communicate or you are mentally unable).

A health care directive allows you to…

  • appoint another person (called an agent) to make health care decisions for you if you become unable to make or communicate decisions for yourself
  • or leave written instructions so that others can make decisions based on your wishes and preferences
  • or do both — appoint a health care agent and leave instructions.

Remember: The most important thing about the health care directive is that you, your family and your doctor each understand your wishes.

If you have a completed health care directive, bring a copy of your health care directive to the hospital. It will be part of your medical chart.

If you don't already have a health care directive, talk about your medical care and treatment wishes with your family and health care team before preparing one. These decisions may be difficult. Your health care team will help you understand how these decisions may affect you.

Questions you might start thinking about now include:

  • What if it becomes necessary for me to make other living arrangements?
  • If I become unable to communicate, what do I want my loved ones to know about my health care wishes?
  • Who do I want to have make decisions for me when I can't speak for myself?
  • At what point would I want to say, "Enough is enough. I want to focus on comfort and quality of life?"
  • What is hospice? Would I ever want to be part of a hospice program?
  • Would I agree to an autopsy to help my family understand my cause of death?
  • Do I want to become an organ donor?
  • What are my preferences for funeral arrangements?

Once a health care directive is written, it can be changed or revoked as long as you are able.


Source: Allina Health Patient Education, Helping Your Heart, fourth edition, cvs-ahc-90648; Allina Health's Patient Education Department, Health Care Directives and Minnesota Law, gen-ahc-91676
Reviewed by: Allina Health's Patient Education Department experts
First Published: 10/04/2002
Last Reviewed: 02/01/2007