Advance Directives
A living will, healthcare proxy, and POLST work together to protect your wishes in a medical emergency. All three are legally valid in all 50 states when properly executed. Creating them is one of the most important things you can do for your family.
Available in all 50 states — no legal restrictions
Advance directives are legal everywhere in the United States. They are completely separate from medical aid in dying laws. Regardless of where you live, you can create these documents today.
Start your advance directive with Sage
Sage guides you through a conversation about your values and wishes. The document is a byproduct of the conversation — not a form to fill out.
chat Start the conversationReviewed by a 50-state licensed physician
The three documents that protect you
Living Will
States your treatment preferences in advance
A living will specifies which medical treatments you do or do not want if you become unable to communicate — for example, whether you want CPR, mechanical ventilation, artificial nutrition, or other life-sustaining interventions in specific clinical scenarios.
A living will is instructional — it guides your healthcare team, but it must be found and interpreted. It cannot respond to unanticipated situations, which is why it works best alongside a healthcare proxy.
Execution requirements vary by state. Most states require 2 witnesses; some require notarization. Your Sage-generated document includes state-specific instructions. Five Wishes is valid in 46+ states and DC.
Healthcare Proxy
Also called Durable Power of Attorney for Healthcare
A healthcare proxy designates a specific person — your healthcare agent — to make medical decisions in real time if you are unable to do so. This person fills the gaps that a living will cannot anticipate. They advocate for you with medical teams, access your medical records, and make treatment decisions based on your known values.
Your healthcare proxy should be someone you trust to honor your wishes even under family pressure, someone who can remain calm in a crisis, and someone who is geographically accessible. Most important: they should know your wishes before a crisis occurs.
Important: Children turn 18 and parents lose automatic legal authority to make their medical decisions. The American Bar Association recommends all adults 18+ designate a healthcare proxy.
POLST / MOLST
Physician Orders for Life-Sustaining Treatment
A POLST is a medical order — not an advance directive — signed by both the patient (or surrogate) and a licensed clinician. It translates your wishes into immediate, actionable medical orders that EMS, hospitals, and nursing facilities must follow. It travels with you across all care settings.
POLST is most appropriate for seriously ill individuals or those in the last year of life. It is not a replacement for a living will or healthcare proxy — it supplements them with an immediately actionable order.
State naming variants: POLST (most states), MOLST (NY, MD), MOST (NC), POST (TN, others), COLST (VT). All function the same way. Colorado APRNs can sign POLST forms as of August 2024.
A physician from the co-op.care network can facilitate a POLST conversation and sign the form. co-op.care membership includes access to POLST facilitation.
How they compare
Five Wishes — a practical option
Five Wishes is a nationally recognized advance directive document that meets legal requirements in 46 states and Washington DC (per the American Bar Association). It is available in 32 languages. It covers all five essential elements: the person you want to make decisions for you, the treatment you do or do not want, how comfortable you want to be, how you want people to treat you, and what you want your loved ones to know.
open_in_newAging with Dignity — Five WishesStoring and sharing your directive
A completed directive is only useful if it can be found. Common failure points: documents in a safe deposit box inaccessible on weekends, unsigned photocopies, documents unknown to the treating medical team.
Give a copy to your physician, healthcare proxy, and primary hospital
Keep an original in an accessible location at home (not a safe deposit box)
Store a digital copy in a platform accessible in emergencies — the ComfortCard digital health wallet provides QR-code emergency access readable by first responders
Consider registering with the MyDirectives national registry or your state's registry if available
CareGoals — guided advance directive conversation
CareGoals is a voice-first, AI-guided conversation that explores your values, experiences you want to avoid, and the people who matter most to you. The resulting document is a state-specific advance directive generated from your answers — not a form you fill out.
A co-op.care physician reviews every CareGoals directive and can facilitate remote notarization (RON) in states that require it. Available as part of the $59/month co-op.care membership, or on its own at caregoals.com.
Beyond the forms — what do you want care teams to know?
An After Note captures your voice, values, and story. It lives alongside your advance directive and travels with your care.
Write an After Note →Disclaimer: Advance directive documents generated through this platform are templates structured to meet state-specific requirements. Legal validity depends on proper execution (witnesses, notarization as required by your state). This is not legal advice. Consult an attorney in your state for advice specific to your situation. Laws change; verify current requirements. Cross-state enforceability of advance directives is not guaranteed in all circumstances.
Content reviewed by a board-certified hospitalist — 50-state licensed. Sources: National POLST (polst.org), NHPCO, Five Wishes / Aging with Dignity, American Bar Association Commission on Law and Aging, CDC National Center for Health Statistics 2022.