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Advance Directives

There may come a time when you become unable to manage your own health care. If this happens to you, you may want a family member or other person close to you making decisions on your behalf. By planning in advance, you can arrange now for your wishes to be carried out. An advance directive is a set of directions you give about the medical and mental health care you want if you ever lose the ability to make decisions for yourself.

Making an advance directive is your choice. If you become unable to make your own decisions, and you have no advance directive, your medical or behavioral health provider will consult with someone close to you about your care. Discussing your wishes for medical and behavioral health treatment with your family and friends now is strongly encouraged, as this will help to make sure that you get the level of treatment you want if you can no longer tell your PCP or other physical or behavioral health providers what you want.

North Carolina has three ways for you to make a formal advance directive. These include living wills, health care power of attorney and advance instructions for mental health treatment.

Living will

In North Carolina, a living will is a legal document that tells others that you want to die a natural death if you:

  • Become incurably sick with an irreversible condition that will result in your death within a short period of time, or;
  • Are unconscious and your health care provider determines that it is highly unlikely that you will regain consciousness, or;
  • Have advanced dementia or a similar condition, which results in a substantial cognitive loss and it is highly unlikely the condition will be reversed.

In a living will, you can direct your provider not to use certain life-prolonging treatments such as a breathing machine (called a "respirator" or "ventilator"), or to stop giving you food and water through a feeding tube.

A living will goes into effect only when your provider and one other provider determine that you meet one of the conditions specified in the living will. You are encouraged to discuss your wishes with friends, family and your provider  so that they can help make sure that you get the level of care you want at the end of your life.

Health care power of attorney

A health care power of attorney is a legal document in which you can name one or more people as your health care agents to make medical and behavioral health decisions for you as you become unable to decide for yourself. You can always say what medical or behavioral health treatments you would want and not want. You should choose an adult you trust to be your health care agent. Discuss your wishes with the people you want as your agents before you put them in writing.

Again, it is always helpful to discuss your wishes with your family, friends and your health care provider. A health care power of attorney will go into effect when a provider states in writing that you are not able to make or to communicate your health care choices. If, due to moral or religious beliefs, you do not want a provider to make this determination, the law provides a process for a non-physician to do it.

Advance instruction for mental health treatment

An advance instruction for mental health treatment is a legal document that tells medical (physical) health providers and mental health providers what mental health treatments you would want and what treatments you would not want if you later become unable to decide for yourself. It can also be used to nominate a person to serve as guardian if guardianship proceedings are started. Your advance instruction for behavioral health treatment can be a separate document or combined with a health care power of attorney or a general power of attorney.

An advance instruction for behavioral health may be followed by a physical health provider or behavioral health provider when your physical health provider or an eligible psychologist determines in writing that you are no longer able to make or communicate behavioral health decisions.

Forms you can use to make an advance directive

You can find the advance directive forms at www.sosnc.gov/ahcdr. The forms meet all the rules for a formal advance directive. For more information, you can also call 1-919-807-2167 or write to:

Advance Health Care Directive Registry
Department of the Secretary of State
P.O. Box 29622
Raleigh, NC 27626-0622

You can change your mind and update these documents at any time. We can help you understand or get these documents. They do not change your right to quality health care benefits. The only purpose is to let others know what you want if you can't speak for yourself. Talk to your primary care provider or call Member Services at 1-855-375-8811 (TTY 1-866-209-6421) if you have any questions about advance directives.