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A Guide to End-of-Life Care Documents

Many people believe they are prepared for end-of-life care if they have created and signed a living will. Unfortunately, medical professionals misinterpret end-of-life care documents more often than you think.

The issue is that medical professionals often have little training in understanding and interpreting living wills, do not resuscitate orders (DNRs), and Physician Orders for Life-Sustaining Treatment (POLST) forms. A common mistake occurs when a medical professional assumes that a patient’s living will include a DNR clause and doesn’t resuscitate the patient. The opposite scenario occurs when medical professionals resuscitate a patient who doesn’t want it. Of course, there are plenty of instances when mistakes were caught before inappropriate action was taken.

To help prevent this from happening, it is a good idea to understand how end-of-life documents work and which ones are best for your situation and wishes. Here is a brief explanation of some healthcare documents to consider. For more information and guidance, seek the counsel of an elder law attorney.

Living Wills

You can use a living will to express your wishes for end-of-life care. However, it is not a legally binding medical order. Medical staff are not required to comply with the wishes stated in a living will, but they are likely to consider them when making decisions concerning your treatment. In fact, a living will really only becomes relevant when you are in a permanent vegetative state, unconscious, or terminally ill. Medical staff may also consult with your designated health care power of attorney (surrogate, agent, or proxy) and family. In your living will, you can specify whether or not you want to be kept alive by artificial means.

DNR Orders

A DNR order is a binding medical order that a physician must sign, and applies specifically to cardiopulmonary resuscitation (CPR). A DNR order indicates that a patient should not have CPR performed on them if they stop breathing or their heart stops beating. However, it does not mean that they have refused all other types of medical assistance, such as defibrillation, mechanical ventilation, intubation, or intravenous antibiotics.

Confusion can occur when DNR orders are wrongly interpreted as orders not to treat the patient at all. If you have a DNR clause in your living will or if you say you don’t want CPR, these are considered your preferences, but they don’t qualify as a DNR order.


A POLST form is a set of medical orders for a patient who is likely to die within a year. The form must be signed by a physician, physician assistant, or nurse practitioner. POLST forms vary from state to state and should be preceded by a detailed conversation about the patient’s prognosis, values and goals, and the potential benefits and harms of different treatments. A POLST form is voluntary and created with the knowledge and consent of either the patient or the patient’s health care surrogate (health care power of attorney, agent, or proxy) and authorized decision maker.

Health Care Power of Attorney Forms

A health care power of attorney allows you to appoint a person you trust to make health care decisions for you if you can’t make them. The language on this form is often combined with a living will to name your health care agents and declare your health care wishes in the same document.

Next Steps

Consult an elder law attorney to determine which health care documents work best for your situation. As your health care needs change, make sure you update your documents and keep your elder law attorney, primary care physician, and health care agent informed of any changes.

Our law firm is dedicated to informing you of issues affecting seniors who may be experiencing declining health. We help you and your loved ones prepare for potential long-term medical expenses and the need to transition to in-home care, assisted living care, or nursing home care.

This article offers a summary of aspects of estate planning law. It is not legal advice, and it does not create an attorney-client relationship. For legal advice, please contact our Houston office today at (713) 582-5088 or schedule a consultation.

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