Document Your Healthcare Values
Completing a Vermont Advance Directive
In your advance directive, you can provide more information about what matters most to you in the event of a health crisis, serious illness, and at end of life AND appoint a health care agent to make decisions on your behalf if needed. Completing an advance directive with treatment preferences will inform your health care agent(s) and health care providers of your values and preferences if you cannot speak for yourself.
The parts of your advance directive that discuss your treatment preferences and health care values are sometimes called the ‘Living Will’ or ‘Treatment Directive’.
Sharing What Matters Most
Often, decisions about the right course of treatment are straightforward and easy to make. But sometimes, these decisions are not so simple. There may be several options, each with different potential risks and benefits, but none is clearly “best.” In these cases, the right course of treatment will depend on your personal goals and priorities.
You can provide general information about:
- Your personal health care values and preferences
- Important religious, faith or spiritual considerations
- Situations in which invasive treatment(s) would or would not be acceptable
- Preferences for palliative and hospice care if you become seriously ill or are dying
- Views on organ and tissue donation
- Funeral and burial arrangements
You can also provide specific information about:
- Cardiopulmonary resuscitation (CPR)
- Breathing machines (ventilators)
- The use of artificial foods and fluids (feeding tubes)
- Time limited trials of treatment to see if you will get better
- Mental health or psychiatric considerations
- Dementia/Alzheimer’s specific considerations
Which Form to Use
All Vermont advance directive forms allow you space to appoint a health care agent (medical decision-maker) and document your treatment priorities. You should pick the ONE form that allows you to share all your thoughts and decisions about future health care. All forms described below are advance directives produced by the Vermont Ethics Network.
In the Appointment of a Health Care Agent form, you can choose your health care agent, an alternate health care agent, and give a brief description of your treatment preferences.
About this form:
- 2 pages
- Recommended for people who have not had many conversations about their treatment priorities yet but know who they would trust to be their health care agent.
- The shortest version of the advance directive
In the VT Advance Directive Short Form, you can choose a health care agent (and an alternate), document your overall health care goals, describe your preferences for end-of-life care, and share your wishes for organ donation and funeral arrangements.
About this form:
- 6 pages
- Recommended who know who they would trust to be their health care agent and have started thinking about their treatment priorities.
- Our most popular form
In the VT Advance Directive Long Form, you can choose a health care agent, document your overall health care goals, describe preferences for end-of-life care, share your wishes for organ donation and funeral arrangements. You will also be able to decide about a significant number of medical treatments, describe your preferences for possible psychiatric care and complete a Ulysses Clause provision if you choose.
About this form:
- 20 pages long
- Recommended for people who have detailed preferences to document, have multiple diagnoses, or individuals who have psychiatric treatment considerations.
- The most comprehensive advance directive form
Changing your Advance Directive:
You can change your mind at any time. If you want to change what your advance directive says, you can update your document by completing a new form and give the new signed and witnessed copies to your agent, your health care provider, your local hospital, and any friends/family you wish. A newer advance directive automatically supersedes previous advance directives.
If your document is registered with the Vermont Advance Directive Registry (VADR), you should also send a copy of the new directive to the VADR with a VADR Administrative Form. You can read more about how to make updates with the VADR here.
Print Resources
Taking Steps (Step 2): A Comprehensive Guide to Medical Decision-Making
Order hard-copies on our Publications Page
More Resources & FAQs:
A Living Will is an older document that was designed to address a situation where a person has a terminal condition and only wants care directed at their comfort and no extraordinary measures taken to prolong their life.
An advance directive is a more contemporary version of the older living will. Advance directives allow an individual to specify the care and treatment they would and would not find acceptable if they were unable to speak for themselves, regardless of whether their condition is terminal. Advance directives also allow for the appointment of a health care agent to make medical decisions for you when needed.
Yes, properly signed and witnessed advance directives are legally recognized in Vermont.
An advance directive is completed by an individual who is capable of making their own decisions. These are preference based documents that guide care and treatment in the future if the individual is not able to speak for themselves. In your advance directive, you can appoint a healthcare agent to speak for you and describe your treatment preferences. Advance directives are not recognized by emergency first responders.
A DNR/COLST order is a medical order created through a shared decision making process between a clinician (MD, DO, APRN, PA) and a patient. These documents require informed consent, will guide the current treatment plan, and are legally recognized by all medical providers, including emergency first responders. Consent for a DNR/COLST can be provided by someone other than the patient if the patient lacks capacity.
You should use the advance directive form for the state in which you reside. To find the form for your state, click here.
You make your own medical decisions as long as you are able to do so. In general, your agent’s authority begins when you lack the capacity to make your own decisions, as determined by a clinician.
If you have a medical emergency outside of a hospital, the first responders are required to provide maximal treatment (unless you have a signed DNR/COLST order) until you can get to a hospital and are evaluated by a doctor. First responders will not follow the instructions in your advance directive. At the hospital, you, your advance directive, or health care agent can guide further decisions.
If you do not want CPR (cardiopulmonary resuscitation) performed on you for any reason, you should talk to your clinician about completing a DNR/COLST so that first responders who come to your home will be able to honor your preference.
Read more about DNR/COLST here.
You may wish to add more pages to your advance directive or attach treatment-specific addendum documents. In order to do so you must:
- Reference your addendums in your advance directive OR reference your advance directive in the addendum. For example, in your advance directive, write “see attached addendums [titles of addendums] with additional information.” Or, in the addendum, write “this is an addendum to my advance directive completed on [date]”.
- Include your name, date and date of birth on each page of your addendum.
- Sign and witness your addendum just as you would an advance directive.
- You must sign and date the document, and two witnesses must also sign and date. Witnesses must be 18 years of age or older, and cannot be your health care agent(s), spouse, siblings, parents, children, or grandchildren.
- Attach copies of all addendum pages to your all copies of your advance directive. If you are completing this addendum after your advance directive was completed, be sure to provide copies of the addendum to everyone with a copy of your directive.
Popular advance directives addendums include:
- A letter to your health care agent about your values and preferences
- Advance care planning worksheets (find examples here)
- Disease-specific advance care planning documents (e.g. Alzheimer’s/Dementia Directives)
