When most people hear “Advance Directive,” they think of end-of-life care because of the history of ADs and well-known cases in the media.  Virginia is a good example of a state that made legislative changes so that ADs can cover more than end-of-life care.  Even though a lot of our website talks about planning for medical and mental health care, you can still plan ahead for end-of-life care, too.


Many people use their ADs to plan for end-of-life care because they have important values and wishes about quality of life and/or life-prolonging treatments.  Also, planning for end-of-life care can be great help to loved ones who are faced with making decisions for the dying person.


It is important to understand what counts as “end-of-life.”  There are two basic categories when talking about end-of-life:

  1. If your death is imminent (very soon), e.g., end-stage cancer.
  2. If you are in a persistent vegetative state, e.g., severe brain damage.



Death is imminent

If your death is “imminent,” that means that your death is very likely to happen soon.  Medical treatment will not help you to recover – it will only keep you alive as long as treatments can.  Treatments like tube feeding, IV fluids, and artificial respiration will not help you recover, they will only keep your bodily functions going.


In your Advance Directive, you are able to write down your instructions about life-prolonging treatment – Do you want all life-prolonging measures?  Do you want no life-prolonging measures?  Do you want most types of life-prolonging treatment, but there are a couple you do not want?



Persistent vegetative state

If you are in a “persistent vegetative state,” that means you are unconscious, and it is reasonably certain that you will never recover, even with medical treatment.  Other terms that people may use include “brain dead,” “permanent coma,” or “a vegetable.”  Although your health care provider may be able to prolong your life through treatment such as tube feeding, IV fluids, artificial respiration, and other means, it is reasonably certain that you will not recover.


In your Advance Directive, you are able to write down your instructions about life-prolonging treatment – Do you want all life-prolonging measures?  Do you want no life-prolonging measures?  Do you want most types of life-prolonging treatment, but there are a couple you do not want?  Do you want life-prolonging measures tried for a certain amount of time before stopping these measures?



Learning more about end-of-life care

We do not give medical information about the dying process on this website.  If you have questions about the use or withdrawal of life-prolonging treatments, we strongly encourage you to talk with a medical professional or turn to resources such as the Hospice Foundation.



A final point

We hope you will take the opportunity to plan ahead for end-of-life care with Advance Directives.  If you do not, however, it is good to know that you can make an Advance Directive orally in the case of terminal illnesses.  Oral ADs are valid when made in the presence of the attending physician and two witnesses.

End-of-Life Care