While conversations about health care wishes are our special sauce, we always get questions about where to store documents (health care proxy, advance directives, etc.) once they have been filled out. Below are common scenarios we hear and suggested answers. More information can be found in Your Guide to Choosing a Health Care Proxy. We invite you to share your ideas in the comments section below!

Q: I’ve picked a health care proxy and thought about my health care wishes. Where can I get the documents to get this all down legally?

Every state in the US and most countries have their own advance directive forms.

• In the United States, the National Alliance for Care at Home’s CaringInfo site can help you find the right forms in your state.
• Most states require two witnesses to sign your form. Usually, your proxy cannot sign as a witness. In other states, notarization is either required or is a substitute for having two witnesses. Check CaringInfo for specifics about your state.
• Be careful of “general” power of attorney documents; these documents usually address only financial matters; they are not health care proxies.

Q: What does my proxy need to know / what do I say to my proxy?

Start up a conversation with your proxy

• First and foremost, if you haven’t yet talked with the person you chose to be your proxy, set up a time and comfy place to talk. For tips to help you have that conversation, visit the Guide to Choosing a Health Care Proxy and go to the section “Talk about it”.
• Make sure your chosen person understands what the health care proxy role is all about. Share this guide on being a health care proxy with them.

Make sure your proxy has all the information they need, so they are prepared to speak for you if needed.

• Give your proxy a copy of the health care proxy form and any other advance directive documents.
• Give your proxy a list of names and contact information for your primary care doctor and any other important members of your health care team. If there is anyone else important to you who your proxy may talk with about your care, give them a list of names and contact information.
• Give your primary care doctor or important members of your health care team your proxy’s name and contact information.

Q: Who do I need to talk to besides my proxy?

Tell more than one person. Tell other important people in your life who you’ve selected as your proxy and that they will make decisions on your behalf.

• Talk to anyone who can help you have a say in your care through the end of life. Share copies of your advance directive with anyone who may need them.

For example: If you pick an adult child to be your proxy and you have other children, talk with each child about what matters to you in your health care. Tell them all who you have chosen as your proxy.

• Let the important people in your life know whom you’ve chosen as your proxy. This doesn’t have to be a detailed conversation—an email or a brief update can suffice.

You might start the conversation like this: “Nat, Melissa and I have talked about my health care wishes and what I want. Please listen to her as she will be my surrogate decision maker. That way, you can simply be at my side without that burden. That will be the greatest support to me when my time comes.”

For example: If you’re remarried and want your spouse to be your decision maker, it’s helpful to notify your adult children of this choice.

• Communicate with anyone who may believe they have a say in your care, particularly at the end of life. For example, is there anyone who may give your health care proxy a hard time? Clearly state who will act on your behalf and inform those you don’t want involved. You can send an email if you’d like. This is especially important for estranged family members or others you wish to exclude. Ensure your health care team is aware of your preferences regarding who is and isn’t authorized to participate in decision-making, and document this.

We hope to avoid the “seagull effect”: when an out-of-towner who may not understand the wishes or the day-to-day of the person being cared for swoops in with good intentions and disrupts the carefully made plans of those know what the person wants.

• If there’s someone outside of legally-recognized family members or a spouse whom you specifically want — or don’t want — participating in your decisions, make sure their involvement (or exclusion) is documented.
• If you have other important documents or objects that that may help people understand your wishes, such as an annotated bible or a journal, make sure people know about them and can find them.

Q: Where should I store my health care wishes and other documents? What are some ways to share my documents with those who will need to access them?

After you’ve had important conversations about your wishes with those important in your life…

Store your documents somewhere accessible. There are many places and ways to store them. (These might include your advance directive, health care proxy, surrogate decision maker, or living will). Most importantly, make sure someone else knows where the documents are, and make sure that person can access them in an emergency. It doesn’t help if it’s in a folder, lock box, or somewhere “safe” if no one knows about it!

Some ideas on where to keep and share documents:

Keep wishes on your phone

• Snap a photo of any documents and create a “health care info” photo album to share. If you’ve had conversations about wishes, write down those wishes in your phone’s notes app. Make sure someone else knows they are there and how to access them. Consider making an audio recording (voice memo) or a video talking about your wishes.

For example: Two spouses talked about their wishes for care and the things they valued most about life and living. One spouse jotted them down and saved them as a note in their phone. Now, whenever their wishes change, or they continue the conversation, they just update the note. Even for those who have a good memory, it’s a helpful reminder about what was talked about and decided!

Email or mail documents (and updates)

• Email an electronic copy of legal documents. Or, at the very least, share a quick summary of your wishes with others. While a quick summary is not necessarily legally binding, health care team members appreciate when family members are on the same page and can reference a note directly from the person being cared for.
• You can update your wishes yearly, or whenever they change. (You can change your mind anytime!) Send an update email with your latest wishes and updated forms (or instructions to access them). You might send the email to your health care proxy, your health care team, your family members, a trusted friend or those who may have a stake in your future care (e.g. a family member who you are no longer close with but may think they have a say in your future care). (Keep a copy of the old document to reduce confusion.)

Keep documents in one place in your home — and tell people where it is.

• Some people like to put health care forms in a file with other important documents. This could be a physical copy in a folder or an electronic copy in a computer file. Make sure people who will need to access the documents know where the physical folder is or what the computer file is called.
• Many individuals have shared with us that they put their documents on the refrigerator with a magnet. Some communities have a “red folder alert” system. In those communities, paramedics know to look for the red folder on the fridge to access written wishes in emergencies (such as an advance directive, do not resuscitate (DNR) order, Portable Medical Orders (POLST) document, or health care proxy. This system is especially helpful in an emergency if there is no one who is present who can remember and share wishes.

Share with a member of your health care team or in your patient portal

• If you have a provider or health care team, email a copy and/or bring a physical copy of your forms (such as health care proxy and advance directive) to your next medical appointment. If you have access to a website that lets you communicate with your health care team (a patient portal that has your digital record of your health and treatment history), you can upload a copy of your documents or share the name and contact information of your health care proxy.
• For tips on talking about what matters to you with your health care team, visit our Guide for Talking with a Health Care Team.

Use an online storage site

• Create or store your documents using one of the many sites available. Be sure to tell your health care proxy or other important people how to access them.

A sampling of storage and creation sites:

A|D Vault/MyDirectives.com & MyDirectives MOBILE (free)

MedicAlert Foundation (fee-based with free options based on need)

My Living Voice (free)

• For more information on storing and retrieving your advance directive, including physical, digital, and video versions, visit this CaringInfo page.

Q: What if I want to change my health care wishes? Do I have to redo my documents?

You can always change your wishes or your designated health care proxy. If you want to make a change:

• Fill out a new form and talk with your health care proxy.
• Tell the people close to you, along with your health care team, about the change.
  • If you choose a new proxy, let your previous proxy know you’ve decided to make a change. You might say, “I’ve been thinking about it, and I’ve decided to change my proxy. Thank you for agreeing to do this for me, but I won’t need you to take on this responsibility anymore.”
• Keep your previous advance directive form and/or health care proxy form in a place where you and others can find it.
  • Helpful hint: Write “no longer accurate” on the old form. Place the new form in the same place with a note that says “Updated on” and write the month, day, and year. This helps keep track the versions.

For more information check out Your Guide to Choosing a Health Care Proxy or Your Guide to Being a Health Care Proxy What other tips do you have from your experience or resources you can recommend? Please share in the comments below.