At Penn State Health, we value your right to make decisions about your medical care. However, an unexpected medical condition can leave people unable to make health care decisions at any age.
Advance care planning helps ensure you get the care you want. The process starts with conversations between you, your health care team and the people who are important to you. Advance directives are forms you can use to document your wishes and specify whom you want to make medical decisions for you.
Advance Care Planning Documents
Penn State Health Power of Attorney Forms
- Health Care Power of Attorney Form (English)
- Health Care Power of Attorney Form (Spanish)
- Health Care Power of Attorney Form (Nepali)
- Health Care Power of Attorney Form (Arabic)
- Health Care Power of Attorney Form (Russian)
- Health Care Power of Attorney Form (Somali)
- Health Care Power of Attorney Form (Ukrainian)
- Health Care Power of Attorney Form (Chinese-Mandarin)
Advance Directive Living Will and Power of Attorney Forms
What Matters to Me – A Workbook for People With Serious Illness
Frequently asked questions
What is advance care planning?
Advance care planning is a process adults can use to identify, document, and respect wishes related to medical care.
Why should I do advance care planning?
An unexpected health condition can arise at any moment. If you are suddenly unable to speak for yourself, it is important that your health care team know your wishes about treatment and whom you want to make decisions for you. Advance care planning, including conversations with your health care team and the people who are important to you, helps everyone to have a better idea of how you want to be cared for.
If I do not complete advance directives, who decides about my health care when I can’t?
In Pennsylvania, health care decisions are made by your next of kin in the order below if you do not name a health care agent:
- Your spouse and adult child not of your spouse
- An adult child
- Either of your parents
- An adult sibling
- Adult grandchildren
- Close friend
What are examples of advance directive forms?
Examples of advance directive forms include:
- Health care power of attorney: A form that allows you to select someone to make health care decisions for you, called a health care agent, when you are unable to make or communicate those decisions yourself.
- Living will: A form that allows you to select what types of health care interventions you would want, or not, if you are not conscious and your condition cannot be cured.
- Pennsylvania Orders for Life Sustaining Treatment (POLST): A form that turns your wishes into a medical order. If you have a condition that cannot be cured and are certain you want to limit health care interventions, it may be appropriate to talk to your health care team about this form.
- Advance directive: Various forms that combine living will and health care power of attorney
I’m ready to complete a health care power of attorney. How do I do it?
- Complete Penn State Health’s simple health care power of attorney form.
- Determine who is best suited to represent your wishes.
- Your health care power of attorney should be someone who is 18 years old or older and who is:
- A family member or close friend whom you trust to make serious decisions.
- Willing to assume the role.
- Willing to discuss your goals and values.
- Willing to make the decisions you would make, even if they don’t agree.
- Able to make decisions in a stressful situation.
- Your health care power of attorney cannot be:
- A health care provider who is involved in your care.
- An employee of your health care provider unless this person is a relative who is not providing health care services to you.
- Your health care power of attorney should be someone who is 18 years old or older and who is:
- You have the option to appoint a second person as your alternate health care agent. The alternate would step in if the first person you name is unable, unwilling, or unavailable.
- If you need assistance with completing advance directives, you can ask your health care team for a referral to a social worker.
I’d like to put some limits on the care I will receive. How do I do it?
- Advance directive
- Pennsylvania Orders for Life Sustaining Treatment (POLST):
- POLST is a form that takes the wishes of an adult and turns them into an order.
- POLST requires the signature of a physician, physician’s assistant, or nurse practitioner.
- POLST is meant for adults who have a limited life expectancy and who want to limit the type of medical interventions they receive.
I have completed my advance directives. Now what do I do?
- Keep the original form with you in case you need to make changes in the future.
- Give a copy of your advance directive to your health care agent.
- Give a copy of your advance directive to any health care teams who care for you. It will be included in your electronic patient chart so your health care team knows your wishes.
- You can upload your advance directive to your patient portal.
You can mail a copy to Penn State Health’s Health Information Services office:
Penn State Health Milton S. Hershey Medical Center
500 University Drive, Attn: HIM
Mail Code HU24
Hershey, PA 17033