By Noël Durman
What is National Healthcare Decisions Day (NHDD), you ask? It’s a reminder to check off an important task that many of us may not even realize we ought to do: discuss and document our preferences for medical care should we become too ill to make decisions for ourselves.
It’s easy to bump this task to the bottom of our to-do lists; no one wants to think about being in a position where they cannot communicate their wishes. Yet, in a crisis, one of the kindest things we can do for our families, loved ones and doctors is to make sure they know the types of treatments we do and do not want to receive. This kind of documentation is known as advance care planning.
In recognition of NHDD on April 16, we’re offering some guidance and resources to help you take the first steps toward planning and documenting your wishes.
Why Planning Ahead Matters
When someone becomes seriously ill or can no longer communicate their own wishes, medical decisions still need to be made. Family members are asked to step in, often without clear guidance on what their loved one would want.
Aaron Zajdel, Manager of the Goodwin Living Care Connections program, educates community members—residents of Goodwin Senior Living Campuses or patients of Goodwin Living Health service lines—about the importance of advance care planning. “These conversations have real benefits,” Aaron said. “Hearing directly from someone about what they would or wouldn’t want medically makes decision‑making easier later on. It’s far easier to carry out someone’s wishes when you’ve talked ahead of time, rather than having to guess in the moment,” he continued. “Ongoing conversations, along with the right documentation, help ensure decisions are calmer, clearer and reflective of your values.”
Advance care planning helps prevent uncertainty. It gives families and care teams something concrete to work from, so they are not left guessing as to the patient’s wishes in difficult moments.
Planning ahead ensures your wishes remains part of the conversation, even if you’re not able to communicate for yourself later on.
Here are some useful resources that can help you get the ball rolling:
- Conversation Starter Guide
A question-based guide to help you think through your values and priorities. - What Matters to Me Workbook
A reflective workbook for clarifying what matters most before talking with family or a clinician.
Key Healthcare Decision Documents, Explained
Many of us hesitate to address our own advance care planning because we find the associated documents confusing. Though the names are similar, the purposes are different, and it’s not always clear which ones apply to you.
Here’s one reassuring fact: none of these documents require a lawyer to complete. Most require nothing more than your signature and either two adult witnesses or a notary. Let’s take a closer look at them to understand each more clearly.
Advance Directive
An advance directive is the legal document that records your healthcare wishes. It’s completed by you. It does not lock you into decisions; it simply gives others a place to start if they ever need one.
Each state has its own requirements in terms of documenting an advance directive. In Virginia, an advance directive includes two parts:
- A living will, which outlines preferences for treatments such as life prolonging measures
- A healthcare agent, the person you choose to represent you if you cannot make decisions yourself
Virginia offers a template for preparing your advance directive. The document must be signed in front of two adult witnesses or notarized.
If you live in another state, AARP has a great reference page offering links to information for each state.
Healthcare Agent (also known as Medical Power of Attorney)
This is the person you trust to make medical decisions if you’re unable to do so. This can also be known as a proxy, or as a medical power of attorney. You usually name them within your advance directive, no separate paperwork is required.
What matters most is that this person understands your values and priorities, which means having a real conversation ahead of time. This person should also be trustworthy, reliable and accessible to make medical decisions for you, if necessary. That may feel hard, but there are tools linked below to help you begin.
How to Choose a Healthcare Proxy walks you through what to look for in a healthcare agent and how to begin that conversation.
DDNR (Durable Do Not Resuscitate)
A DDNR is a medical order that tells healthcare providers not to attempt CPR if your heart stops and you stop breathing. It’s completed by you and your doctor together, so you can ask your doctor if you would like to set this up.
If they do not see proof of a DDNR, emergency responders are legally required to attempt resuscitation, even if other documents (like your advance directive) say otherwise. First responders are trained to look behind the front door to the dwelling and on the refrigerator for a completed DDNR form. The state of Virginia also participates in a DDRN jewelry program where people can submit their completed DDNR form and receive a bracelet or anklet that indicates your DDNR status.
POLST (Physician Orders for Life Sustaining Treatment)
A POLST is a medical order that covers resuscitation, preferred level of medical intervention, preferences on artificial nutrition, hospitalizations, other life sustaining treatments and hospice. It’s completed through conversation with your doctor or nurse practitioner who knows you. The POLST form (template here) is typically appropriate for people who are seriously ill or have an advancing condition.
Additional Resources
For more guidance on preparing an advance directive, this resource offers a more visual, step-by-step option combining videos, questions and printable forms.
Clearing Up Common Concerns
It’s normal to feel some hesitation about documenting your healthcare wishes. Let’s clear up a few common concerns that we often hear from those exploring advance directives.
“Where do I need to file these documents so that my loved ones and healthcare professionals have them in an emergency?”
Once completed, copies should be shared with your healthcare agent and your physician. They should also be kept in a place that’s easy to access at home. Let close family members know where the documents are stored so that they can find them easily in an emergency.
“If I fill this out, does that mean doctors won’t try to treat me?”
Advance care planning is about your wishes, not less care. It helps your care team understand what matters to you and when certain treatments would or wouldn’t be wanted.
“Once it’s signed, am I locked in?”
These documents can be updated at any time. You’re allowed to change your mind as your health, values or life circumstances change.
“Isn’t this only for people who are very sick?”
Advance care planning is for adults of all ages, and it’s often most helpful when done before a crisis.
Keeping Plans Up to Date
You may already have some of these documents in place, and that’s a great start. What matters most now is making sure they still reflect your wishes today. Health changes, family roles shift, and what felt right even just last year may feel different now.
Even small updates like reviewing who will serve as your healthcare agent or sharing what matters most to you can make a meaningful difference for you and your loved ones when decisions need to be made quickly.
Making Healthcare Decisions: Where to Start
Advance care planning doesn’t have to happen all at once. As Aaron reminds us, “National Healthcare Decisions Day is a reminder that starting small still counts and can have lasting benefits for your care.” A single conversation, a few minutes of reflection or one completed document can make a meaningful difference.
The hardest part is often just beginning. And so, on this NHDD, we invite you to start by choosing an option below that fits your time and energy. Your loved ones will thank you for taking the time to make your wishes clear!
If you’ve got five minutes:
Think of one person you trust and let them know you’d like to talk about healthcare wishes sometime soon.
If you’ve got 15 minutes:
Use a guided worksheet like the What Matters to Me Workbook to reflect on your values and priorities before turning to any paperwork.
If you’ve got an hour:
Complete your advance directive and review it with your healthcare agent.
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Noël Durman is Director of Hospice Giving at the Goodwin Living Foundation, where she works to connect donors with the meaningful care Goodwin Hospice provides every day. She brings more than 20 years of nonprofit fundraising experience spanning international conservation, conflict resolution and services for older adults.
