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What's a Health Care Directive?

ASB May 01, 2019 | 5 min read N/A

Planning ahead is an important part of life. Many of us plan ahead for exciting major life events like buying a home or retirement. It’s also important, however, to plan for the unexpected. Deciding what advance health care decisions you prefer if you become unable to make them for yourself is daunting, to say the least. In addition to being a difficult topic to think about, there’s also a lot of confusing medical and legal language involved.

At American Savings Bank, we know that you don’t want to spend any more time than you have to on complicated matters like this. We’ve put together a list of suggested go-to tips to help you better understand your options when it comes to advance care directives. But, first and foremost, we strongly recommend speaking with your attorney before making these important decisions.


You may have heard the term “living will” before. A living will is your declaration of what types of treatments or medical procedures you will or won’t accept if you become unable to make these decisions for yourself. These personal instructions for end-of-life care generally include instructions for the administration of pain medications or the use of treatments to prolong life without a chance for recovery.

If you’re confused by the term, you’re not alone. To prevent confusion among Hawaii residents, the State of Hawaii stopped using the term “living will” and instead uses the term “individual instruction.” Individual instructions are only one part of an advance health care directive. Health care directives can be legal documents or oral instructions, usually given to your doctor to be included in your medical records. They cover your individual instructions for end-of-life treatment as well as other important health care concerns, such as appointing a person of your choice to make decisions for you.


Your health care directive lets you state exactly what your end-of-life decisions are even if you can’t communicate those wishes in the future. In addition to your individual instructions, or living will, your directive can include:

  • DURABLE POWER OF ATTORNEY FOR HEALTH CARE: A legal document that appoints a person of your choice to make decisions on your behalf if you are unable. Known as your “health care agent,” many Hawaii residents think this person must be your attorney. This isn’t true; your “health care agent” can be anyone you trust. Many people choose to appoint their adult child, spouse, or trusted family friend. Generally, the only restriction in choosing an agent is that the person can’t be an owner or employee of the medical facilities where you wish to receive care unless you are related.

  • PROVIDER ORDERS FOR LIFE SUSTAINING TREATMENT (POLST): Not technically a health care directive, POLST are provided in a form signed by a physician or Advanced Practice Registered Nurse (APRN) and used for immediate action. Generally, a POLST form is used as a summary of sorts that details what is included in a person’s advance health care directive. When a medical decision needs to be made, the instructions from a health care directive are documented on the POLST form. The form allows medical professionals to act upon your wishes right away.

  • DO NOT RESUSCITATE (DNR) ORDER: A health care order made to a doctor or other medical professionals, such as emergency crews, refusing CPR in the event a person has stopped breathing or is suffering a heart attack. DNR orders can be made by a health care agent or, if the patient is able to communicate, by the patient themselves in an emergency. Many people who wish to include a DNR order add it to their health care directive so that the decision is made well before an emergency takes place.

  • ORGAN DONATION: Unlike other health care directives, organ donation is generally made through the Department of Motor Vehicles. You can choose to become an organ donor when you apply for or renew your driver’s license. If a person has specific wishes for their body or organs, they can include additional instructions on their health care directive document.



Though it can be tedious to go through the legal language used in advance directives, it should be an important part of your life planning process. Fortunately, Hawaii has made it easy to create your own health care directive. The state provides a fillable form that can be downloaded and completed on your computer. They also include a checklist so that you know you’re on the right track to creating a legally accurate directive.

Be sure to speak with your attorney about your health care directive options. As you think about your end-of-life treatment wishes, be sure to remember the financial aspect of health care planning. A life insurance or long-term care policy may help your family members pay for the treatment you wish to receive. Planning for the end of your life can be uncomfortable, but remember that by making these decisions now, you will save your family from difficult decisions in the future.