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Advanced Directives

There may come a time when you become unable to manage your health care and a family member or other person close to you is making decisions on your behalf. By planning, you can arrange now for your wishes to be carried out. An advanced 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 advanced directive is your choice. If you become unable to make your own decisions, and you have no advance directive, your provider/doctor or behavioral health provider will consult with someone close to you about your care. We strongly encourage you to discuss your wishes for medical and behavioral health treatment with your family and friends now. This will help to make sure that you get the level of treatment you want if you can no longer tell your provider/doctor or other physical or behavioral health providers what you want.

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

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;
  • Are unconscious and your doctor 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 reserved.

In a living will, you can direct your provider/doctor 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 doctor and one other doctor determine that you meet one of the conditions specified in the living will. Discussing your wishes and friends, family and your doctor now is strongly encouraged so that they can help make sure that you get the level of care you want at the end of your life.

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 doctor. A health care power of attorney will go into effect when a doctor 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 doctor to make this determination, the law provides a process for a non-physician to do it.

An advance instruction for mental health treatment is a legal document that tells doctors 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. A doctor or behavioral health provider may follow an advance instruction for behavioral health when your doctor or an eligible psychologist determines in writing that you are no longer able to make or communicate behavioral health decisions.

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

Advanced Health Care Directive Registry
Department of the Secretary of State
PO Box 29622
Raleigh, NC 27626-0622

You can change your mind and 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 cannot speak for yourself. Talk to your Primary Care Provider (PCP) or call Member Services at 1-833-552-3876 (TTY: 711) if you have any questions about advance directives.