Advance Directives

Advance Directives are legal documents which express your wishes regarding your healthcare treatment should you become terminally ill or permanently unconscious. 


While state laws vary, most states provide two documents as a means for doing this – a Living Will and a Durable Power of Attorney for Health Care (DPOA or Health Care Proxy).

 You may have one or both. If you have completed an Advance Directives form, please provide National Home Health Services with a copy of your signed document.

You may choose to discuss these matters with an attorney, although there is no requirement to do so. 

Advance Directive forms are available at PREPARE-Advance-Directive-English.pdf or you may ask your home health team member, doctor, or insurance provider for the forms. Anyone 18 or over can make his/her own determination by signing Advance Directives.

Under federal and state law, National Home Health Services is required to explain your rights to make personal decisions regarding your medical care and to ask whether or not you have documented your wishes. 

We are also required to provide the following information:

Durable Power of Attorney

The Durable Power of Attorney for Health Care allows you to designate another person as your agent to make health care decisions should you become mentally or physically unable to do so.

Your agent should be an adult relative or close friend whom you trust to carry out your wishes.

 Be sure this person is aware of what you want and has a copy of your Durable Power of Attorney for Health Care. 

In most states your physician cannot be your agent.

The Durable Power of Attorney for Health Care becomes effective when you are temporarily or permanently unable to make your own decisions about your treatment. 

The document is no longer in effect when you are ready to resume decision making for yourself.

Living Will Declaration

Generally, a Living Will expresses your desire to be allowed to die when you are permanently unconscious or terminally ill and unable to communicate. It recognizes your wish not to prolong life artificially through life–support technology or artificially supplied food and water.

While a Durable Power of Attorney for Health Care appoints another person to make health care treatment decisions for you, a Living Will gives your instructions directly to doctors and other caregivers.

If you have chosen not to sign a Living Will Declaration, most states allow your next-of-kin to authorize decisions on your behalf.


“Do Not Resuscitate” (DNR) means no attempt to revive a patient will be made. You may have heard it called a “No Code.” This is a written order by a physician instructing staff not to begin Cardio Pulmonary Resuscitation (CPR) on a patient if the heart or breathing stops.

 This order is written only after the physician talks with the patient and/or the family. Usually it is to prevent resuscitation on a patient whose condition is terminal.

Life Sustaining Treatment

Life Sustaining Treatment is any medical or surgical procedure used to prolong life when the underlying medical problem cannot be reversed.

Some of the most commonly used measures are mechanical ventilation, which pumps air  into the lungs by a special machine called a ventilator, and nutritional support for people who cannot swallow, digest, or absorb food by mouth.

Physician Orders for Life-Sustaining Treatment (POLST)

POLST is a form (in the state of California, printed on bright pink paper) that clearly states what kind of medical treatment patients want toward the end of their lives.

POLST helps give seriously ill patients more control over their treatment. The form is signed by the patient and their doctor, nurse practitioner, or physician assistant. The form works even if the patient later loses the ability to say what he or she wants.

POLST also helps you talk with your health care team and your loved ones about your choices. In this way, POLST can help reduce patient and family suffering, and makes sure that your wishes are known and honored. For more information about California POLST, go to or ask your home health team member, doctor, or insurance provider for the forms.