Advanced Directives and Healthcare Planning
Give the People You Trust Clear Direction for Medical Decisions
Healthcare planning is not only about end-of-life decisions. It is about deciding who should speak for you if an illness, accident, surgery or other medical event leaves you temporarily or permanently unable to communicate your wishes.
An advance directive can identify a trusted healthcare agent and document important treatment preferences before a crisis occurs. Thoughtful planning can help your family, physicians and other healthcare providers understand who has authority and what matters most to you.
The Law Office of Dawn Trainor-Fogleman provides personalized, mobile advance directive and healthcare planning throughout Maryland and Washington, D.C., including Frederick, Damascus, Urbana, Hagerstown, Germantown, Gaithersburg, Rockville, Silver Spring, Olney, Bethesda, Columbia and Ellicott City.
What Does an Advance Directive Do in Maryland?
An advance directive is a legal statement about your wishes for healthcare if you cannot make or communicate an informed decision yourself.
The document may allow you to appoint a healthcare agent, record treatment preferences or do both. Your healthcare agent is the person authorized to participate in medical decisions when the conditions stated in the document and Maryland law are met.
A living will is the part of healthcare planning that communicates treatment instructions. It does not replace the value of naming a trusted person who can respond to circumstances that may not have been anticipated when the document was prepared.
What We Commonly See Leading Maryland Families to Begin Healthcare Planning
People rarely begin by asking for a specific legal form. They usually begin because a life event has made an unanswered healthcare question feel more immediate.
“My parents are getting older, and we do not know what they want.”
Adult children may be involved in appointments and caregiving but still have no clear authority or written guidance if a parent becomes unable to make an informed decision.
Planning response: An advance directive can identify the healthcare agent, alternate agent and treatment preferences before a medical emergency creates additional pressure.
“I am having surgery or beginning medical treatment.”
Even a planned procedure can raise questions about who should speak with physicians, receive information or make decisions if an unexpected complication occurs.
Planning response: Create or review the advance directive, healthcare agent appointment and HIPAA authorization before treatment begins.
“My spouse knows what I want, but nothing is written down.”
Conversations are valuable, but memories and interpretations may differ when relatives are under stress or facing unfamiliar medical choices.
Planning response: Document the wishes, formally name the appropriate agent and provide copies to the people who may need them.
“My adult child recently turned 18.”
Once a child becomes a legal adult, parents may no longer have automatic authority to receive medical information or make healthcare decisions simply because they are the parents.
Planning response: The young adult may choose trusted people to receive information and act if the young adult cannot communicate independently.
“My siblings and I do not agree about our parent’s care.”
Family disagreement can become more difficult when no healthcare agent has been appointed and the parent’s treatment preferences were never clearly documented.
Planning response: Allow the individual to choose the decision-maker and communicate wishes while the individual can still participate in the planning.
“We already completed wills, so we thought we were covered.”
A will generally addresses matters after death. It does not provide complete instructions for healthcare decisions that may arise during life.
Planning response: Add an advance directive, healthcare agent appointment, HIPAA authorization and financial power of attorney to create a more complete lifetime plan.
Healthcare Planning May Involve More Than One Document
Each document has a different purpose. They should be coordinated so your family and healthcare providers understand who may act, what information may be shared and what preferences you have expressed.
Advance Directive
Records healthcare instructions, names a healthcare agent or combines both forms of planning in one document.
Healthcare Agent Appointment
Identifies the person authorized to participate in medical decisions when you cannot make or communicate them yourself.
Living Will
Documents preferences about treatments and life-sustaining procedures under specified medical circumstances.
HIPAA Authorization
Allows designated individuals to receive protected medical information when the authorization applies.
Five Wishes
May help communicate personal, emotional and comfort-related wishes alongside medical and decision-making preferences.
Financial Power of Attorney
Addresses designated financial and legal matters rather than medical decision-making and should be coordinated with the healthcare plan.
Healthcare Agent vs. Living Will: What Is the Difference?
One appoints a person. The other records treatment instructions. Many people benefit from using both because a written document cannot anticipate every medical circumstance.
A healthcare agent is different from a financial agent. The person authorized to make healthcare decisions is not automatically the same person authorized to manage financial accounts, property or legal matters.
Who Should You Choose as Your Healthcare Agent?
The closest relative is not always the person best prepared to serve. Your healthcare agent may need to communicate with physicians, ask difficult questions, manage disagreement and advocate for decisions that reflect your wishes.
The right person should understand your values, be willing to accept the responsibility and remain able to participate during an emotional or medically complicated situation.
Conversations Matter, but Written Planning Gives Families More Direction
Many people assume their closest relatives will know what they want and will automatically be allowed to carry out those wishes. Medical situations can be more complicated than expected, especially when multiple relatives are involved or the family has never discussed specific treatment preferences.
Written planning identifies the person you trust and gives that person a clearer foundation for communicating with medical professionals.
It is also important to make sure the agent and appropriate healthcare providers know the document exists and can obtain it when needed.
Is It Time to Review Your Advance Directive?
A document created years ago may still name people who have moved, died, become unavailable or are no longer the right choice. Your own health, relationships and treatment preferences may also have changed.
- Your chosen healthcare agent is no longer appropriate
- Your alternate agent is unavailable or was never named
- You married, divorced or entered a new long-term relationship
- You received a new diagnosis or experienced a major health change
- Your treatment wishes or personal values have changed
- You moved to Maryland from another state
- Your family does not know where the document is stored
- Your physician does not have a current copy
Your Healthcare Agent and Financial Agent May Have Different Responsibilities
A healthcare agent focuses on medical decisions. A financial agent acts under a power of attorney to handle the financial and legal responsibilities granted in that separate document.
Some people choose the same trusted person for both roles. Others select different people based on their skills, location, availability or family dynamics.
The documents should be reviewed together so the people involved understand their authority and can coordinate when a medical event affects both healthcare and financial responsibilities.
Advance Directive Planning That Comes to You
Traveling to a law office can be difficult for older adults, caregivers, busy families and people preparing for surgery or managing medical limitations. Dawn provides mobile estate planning consultations so these important conversations can take place in a familiar and convenient environment.
Serving clients throughout Maryland and Washington, D.C., including Hagerstown, Frederick, Damascus, Urbana, Germantown, Gaithersburg, Rockville, Silver Spring, Olney, Bethesda, Columbia and Ellicott City.
Schedule a Consultation View the Documents ChecklistFrequently Asked Questions About Advance Directives in Maryland
What is an advance directive?
An advance directive is a legal statement about future healthcare decisions. It may name a healthcare agent, document treatment preferences or include both forms of planning.
Is an advance directive the same as a living will?
Not exactly. A living will records treatment instructions. An advance directive may also appoint a healthcare agent who can participate in decisions when you cannot make or communicate them.
Who should I choose as my healthcare agent?
Choose someone who understands your wishes, communicates clearly, remains calm under pressure and is willing to advocate for your preferences. Consider naming an alternate if the first person cannot serve.
Does my spouse automatically make every healthcare decision?
Do not rely solely on marital status. Naming a healthcare agent and documenting wishes creates clearer authority and guidance, particularly when multiple relatives or complicated medical circumstances are involved.
Can I change my advance directive later?
Advance directives can generally be updated or revoked while the individual has the required capacity. When changes are made, updated copies should be given to the agent, healthcare providers and others who relied on the prior document.
Does my healthcare agent manage my money?
Not solely because the person is your healthcare agent. Financial authority is addressed through a separate financial power of attorney or another applicable legal arrangement.
Should an 18-year-old have healthcare documents?
An adult child may choose to name a trusted healthcare agent and authorize appropriate access to medical information. This can be especially helpful when the young adult is attending college, traveling or living away from home.
Where should I keep my advance directive?
Keep it somewhere accessible rather than in a location no one can reach during an emergency. Your healthcare agent, alternate agent and appropriate healthcare providers should know about the document and have access to a current copy.
Can Dawn meet with us at our home?
Mobile consultations are available throughout many Maryland communities and Washington, D.C. Availability may depend on the location, scheduling and the type of planning required.
Healthcare Planning Should Work With Your Other Estate Planning Documents
An advance directive addresses healthcare decisions, but it does not replace a will, financial power of attorney, beneficiary review or appropriate trust planning. Reviewing the documents together helps prevent gaps and conflicting instructions.