Living Wills, Healthcare POAs, DNRs, and POLSTs Explained

There is a difference between Living Wills, Healthcare Powers of Attorney, and Do-Not-Resuscitate orders (DNRs) and Physician Orders for Life-Sustaining Treatment (POLSTs), but they all issue instruction on similar topics and often get confused with one another. 

Everyone needs a Living Will and a Healthcare POA.  A DNR, however, is only appropriate at a certain stage in life or with certain medical conditions.  To further complicate matters, many Living Will provisions are included in Powers of Attorney documents.  Each state determines the type, format, and language of their documents.  In Maine, the Advance Care Directive is both a Living Will and Healthcare POA combined.     

  • A Living Will is a document where you state that if you have an irreversible or incurable disease that will cause your death, or if you are permanently unconscious with no reasonable expectation of recovery, then you are providing certain instructions regarding being kept alive by artificial means.
  • A Healthcare Power of Attorney is a document where you appoint someone else, known as your Agent, to make health decisions for you if you cannot make them for yourself. If you are unconscious or not competent, your Agent makes decisions in your stead.  Where the Living Will covers end-of-life issues, the Healthcare POA provides coverage for medical decisions in circumstances where you may not be conscious or competent to make them. 
  • A Do-Not-Resuscitate order is a specific direction to your physician and medical staff not to perform CPR or other life-saving measures. In the event of cardiac or pulmonary arrest, you are electing not to be resuscitated.  If you are of an advanced age or have a terminal illness, you may decide that you want to be resuscitated.  If you do not believe in medical intervention, then a DNR might be appropriate.  If you are healthy and believe you still have many good years of life left, a DNR would prohibit you being brought back to life if, for example, you had a heart attack at the age of 45. 
  • A POLST order, or Physician Orders for Life-Sustaining Treatment, is for people with serious advanced illness or frailty who are expected to do within a year.  People in this stage often need frequent emergency services and the DNR only addresses situations where the no pulse is detected, so the POLST order was created to include DNR terms and better clarify the other types of treatment needs.  The order can only be drawn up by medical personnel.

In Maine, the Advance Directive Form provided for free by the state covers all of these provisions in one 17-page document.  Do not need to complete the DNR portion if you do not want or need it.  The rest of the document provides the instruction of a Living Will and a Healthcare POA.

Under Maine law, these documents require two witnesses (who are not named in the document) and do not need to be notarized, but we recommend that you have them notarized because it may be required in other states, and you never know where your medical emergency may occur.

If you have documents prepared by an estate planning attorney, they will likely incorporate some form of an Advance Directive document, which includes all of the living will provisions and the appointment of an agent, and may also include burial and organ donation instruction.  You should not complete a separate Advance Directive form unless you are intending to revoke the one prepared by your attorney.

Your physician should have a copy of your document, as should the person(s) named as Agent(s).  If you are alive and competent, medical staff will seek your input on care.  When you are no longer able to act for yourself, your Agent will act as your voice.

These documents can be revoked and amended by completing a new one, destroying copies of the old one, and sending replacements to your medical providers and Agents.

Rev 2/24

The information presented on this website is general in nature and not intended to be legal advice. No attorney-client relationship will exist with Jones, Kuriloff & Sargent, LLC unless agreed to in writing. Please contact us to discuss your particular situation.

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