Create an Advance Care Directive
Information For Facilitators

Getting Started

Remember, advance care planning (ACP)
and the Advance directive (AD) are for

Yourself

To make sure your choices are respected

Your Agent

So they know what to do and feel confident in their role

Your Clinicians

So they can give you the care you want and avoid what you don’t want

So how do you choose
a Health Care Agent?

It’s important to choose someone you trust to speak for you if you can’t speak for yourself. This person is your health care agent. Sometimes also called a healthcare Power of Attorney, healthcare surrogate, or healthcare decision maker. Think about who knows you well, who you feel comfortable talking about your health with, will respect your wishes, and can handle medical decisions in a crisis.

In Virginia, if you do not name an agent, there is a legal order of decision-makers. You can read more here.

By naming your agent in an AD, you can make sure the right person is in charge.

  1. A legally appointed guardian for the patient; or
  2. The patient’s spouse, except where a divorce action has been filed and the divorce is not final; or
  3. An adult child/children of the patient; or
  4. A parent/parents of the patient; or
  5. A sibling(s) of the patient; or
  6. Any other relative of the patient in the descending order of blood relationship; or
  7. Except in cases in which the proposed treatment recommendation involves the withholding or withdrawing of a life-prolonging procedure, any adult who (i) has exhibited special care and concern for the patient and (ii) is familiar with the patient’s religious beliefs and basic values and any preferences previously expressed by the patient regarding health care

Who do you think would be the best to be your health care agent?

What About Special Health Needs?

  • Dementia or memory loss
  • Mental health conditions
  • Chronic illnesses (like diabetes, cancer, or heart disease)
  • Intellectual, cognitive, or physical disabilities
  • Military service-related health issues

Everyone is presumed to be able to make an Advance Directive unless a court says otherwise. If you live with one of these conditions, there may be extra tools to help you communicate your wishes. Look for links on this site for resources specific to your condition.

Understanding Capacity

In Virginia, all adults are presumed to have the capacity to make an Advance Directive. (See Virginia Code § 54.1-2983.2.)

Capacity means the ability to understand information, make choices, and communicate those choices. An Advance Directive is created while you have capacity. It is used only if two doctors determine that you no longer have capacity to make medical decisions. When you regain capacity, you can speak for yourself again and the advance directive goes back to being held ‘in suspension’, or waiting for when you might need it again.

Complete an Advance Directive

What’s the Difference Between Agent,
Guardian, and Power of Attorney?

Health Care Agent

Named in an AD. This person speaks for you about health care only when you can’t. Also can be called a Healthcare Power of Attorney.

Power of Attorney (POA)

Handles your financial and legal matters. A POA does not make medical decisions unless they are also your health care agent.

Guardian

Appointed by a court if no other legal decision-maker is in place and you can’t make decisions for yourself. You can complete an AD and name an agent before you are appointed a guardian.

Advance Care Planning is a gift to yourself and to those who care about you. It’s never too early to start.

Complete an Advance Directive