Advance Directives

Peace of mind for you and your loved ones with advance planning

Communicate Your Health Care and End-of-Life Wishes 

Most people don’t want to burden their family members with tough decisions, yet few have communicated their end-of-life wishes to their loved ones. It’s a difficult but necessary conversation to have.

Learn more about your options and how to get that conversation started.  

Advance Directives 

An advance directive communicates your goals and wishes for the care you’d like to receive if you become too sick to make health care decisions on your own. You can outline in advance the kinds of treatments you do or don’t want.  

While advance directives are useful, they can’t cover every situation that comes up or every decision that needs to be made. That’s why naming a health care proxy is important. A proxy is a person you appoint to make these decisions for you — the proxy becomes your voice when you can’t speak for yourself.  

In Massachusetts, if you cannot make or express your own health care decisions, a completed health care proxy form is the only legally binding document related to your health care. That’s why it’s important to make plans and complete proxy forms in advance.  

Getting Started 

When it’s time to start the conversation, BID–Milton offers resources from  The Conversation Project. The Conversation Starter Kit provides a roadmap for how to best approach loved ones and address end-of-life wishes.  

Health Care Proxy and Advance Planning 

Learn more about choosing a health care proxy and download the health care proxy form.  

Learn more about advance directives, end-of-life planning, health care proxy, hospice care, medical orders for life-sustaining treatment (MOLST) and palliative care with our Know Your Choices: A Guide for Patients with Serious and Advancing Illness. To download the guide in other languages, visit Massachusetts End of Life Care

For more information, speak with a member of your health care team, including your doctor, nurse, social worker or chaplain.  

Frequently Asked Questions

What is a health care proxy?

A health care proxy (sometimes called a health care “agent”) is the person you choose to make medical decisions on your behalf if you become unable to make them yourself.

It’s never too soon to choose a proxy. Everyone 18 and older — whether healthy or sick — should complete a health care proxy form as serious medical conditions can come on suddenly. It may be helpful to think of your proxy as a type of insurance: You hope you won't need to use them, but if you do, you’re prepared. 

Whom should I choose as my proxy?

Your health care proxy should be someone who understands and respects your wishes and is willing to communicate them to your medical team, even if it's difficult. Most often, spouses and immediate family members are chosen to be a health care proxy, but you can name anyone you'd like. 

There are only a few rules regarding who can't be named a health care proxy: 

  • You cannot name anyone under 18. 
  • If you're currently a patient at a health care facility, you cannot name an employee of that facility as your agent (unless the person is a relative). 
  • You cannot name a member of your current care team. For example, a doctor or nurse can't provide care for you and serve as your proxy at the same time. 
How do I assign a health care proxy in Massachusetts? Do I need a lawyer or a notary?

No. You can fill out a health care proxy form at any time. You do not need a lawyer or notary nor does your proxy need to be present when you fill out the form.

Do I need witnesses?
Yes. For the form to be complete, it must be signed by you (or your authorized representative) and witnessed by two adults, neither of whom can be your proxy. Ideally, your witnesses should be someone you know. If necessary, hospital staff can serve as witnesses.
Do I need a health care proxy if I have a living will or have otherwise expressed my wishes?

Yes.  A health care proxy differs from a living will or other forms individuals may use to outline their wishes. While living wills and other planning forms are useful tools, they don't cover every situation that may arise or every decision that may need to be made. That’s why having a proxy is so important.

Your proxy can be your voice and can speak for you no matter what health care decisions need to be made. Additionally, in Massachusetts, if you're unable to make or express your own health care decisions, a completed health care proxy form is the only legally binding document related to your health care.  

May I have more than one person as my proxy?

In short, No. However, in Massachusetts, you may name one “primary” proxy and one “alternate” proxy. The alternate would only step in if your primary proxy was unavailable or was unable or unwilling to serve. 

Can family and friends who are not my proxy also be involved in my health care decisions?

Yes.  A larger circle of family and friends can be involved in decisions about your care. In fact, people who are close to you might be extremely helpful if your proxy needs to make difficult choices about your care. Talking to your proxy about who should be part of this process is important. Still, in the end, your health care team will look to your proxy to speak for you. 

If a family member doesn’t agree with care plans that are being made or believes that your proxy is not carrying out your wishes, he or she may go to court to legally challenge your proxy’s decisions. 

When does the proxy make decisions for me?

Your proxy makes decisions for you only after your doctor determines you're unable to make or express decisions about your care.

Once your proxy begins making decisions for you, they'll have access to any medical information you would have access to yourself. Your proxy speaks for you only if you are unable to communicate your wishes. If your doctor determines your ability to speak for yourself has returned, your proxy no longer speaks for you. 

What if I change my mind about who my health care proxy should be? 

You may change your mind at any time. Be sure to tell your health care team about the change. Your signed proxy form will be cancelled if: 

  • You fill out a new form later. 
  • You legally separate from or divorce your spouse and your spouse was named as your agent. If you wish to continue using that person as your proxy, you can do so by completing a new health care proxy form with them post-divorce.
  • You tell your agent, doctor or other health care provider — verbally or in writing — that you changed your mind about your proxy. 
What happens if I don’t have a health care proxy?

You don’t need a health care proxy to receive care. If you don’t have one, your health care providers automatically turn to your family for guidance regarding your wishes. If you haven’t told them what you would want in a particular situation, they'll be left to guess which could result in them making decisions that you wouldn't want them to make.

You can help prevent your loved ones from experiencing unnecessary stress and anxiety by selecting a proxy and having a conversation about your wishes ahead of time.

Without a health care proxy, certain decisions may need to be settled in court, such as nursing home placement and familial disagreements regarding your care.

What happens if I go to a hospital other than BID Milton?

If you go to another hospital in Massachusetts and you have a copy of your proxy form, you don’t need to fill out a new one. If you go to a hospital in another state, your proxy form will be honored in most cases.