{"id":8820,"date":"2026-02-16T17:10:25","date_gmt":"2026-02-16T22:10:25","guid":{"rendered":"https:\/\/carepatrol.com\/baltimore\/?p=8820"},"modified":"2026-02-16T17:10:25","modified_gmt":"2026-02-16T22:10:25","slug":"advanced-directives-why-they-matter-more-than-ever-and-how-to-keep-them-current","status":"publish","type":"post","link":"https:\/\/carepatrol.com\/baltimore\/advanced-directives-why-they-matter-more-than-ever-and-how-to-keep-them-current\/","title":{"rendered":"Advanced Directives: Why They Matter More Than Ever (and How to Keep Them Current)"},"content":{"rendered":"<p>When we help families with senior care decisions, one of the most important conversations we encourage is about <strong>advanced directives<\/strong>. These are documents that give older adults a voice in their care when they can\u2019t speak for themselves. At CarePatrol of Baltimore we view advanced directives not as heavy paperwork but as empowerment\u2014preserving dignity, guiding decision-making and avoiding uncertainty. With lessons learned in the post-COVID-19 world and Maryland-specific legal considerations, now is the time to review or update your directives, and by all means create them if you haven\u2019t already.<\/p>\n<h2><strong>What Are Advanced Directives?<\/strong><\/h2>\n<p>\u201cAdvanced directives\u201d is an umbrella term for documents such as:<\/p>\n<ul>\n<li>A <strong>living will<\/strong> (sharing preferences about end-of-life medical care)<\/li>\n<li>A <strong>durable power of attorney for health care<\/strong> (naming a trusted person to make medical decisions if incapacitated)<\/li>\n<li>Other instructions like a <strong>Do-Not-Resuscitate (DNR) order<\/strong>.<\/li>\n<\/ul>\n<p>These activate only when someone cannot make decisions themselves or communicate. Without them, decisions often fall to family, healthcare proxies or courts\u2014sometimes leading to conflict or care choices that may not align with the older adult\u2019s wishes.<\/p>\n<h3><strong>Why They Are More Important Now (Post-COVID-19 Insights)<\/strong><\/h3>\n<p>The COVID-19 pandemic brought into sharp relief how quickly an older adult\u2019s health status can change, how isolation and limited visitation can affect decision-making, and how hospital and long-term-care settings may move rapidly. Many families faced urgent decisions about ICU admission, ventilator support or hospitalization with incomplete knowledge of their loved one\u2019s preferences.<br \/>\nAs a result:<\/p>\n<ul>\n<li>Advanced directives are no longer just about \u201cend of life,\u201d but about serious illness, sudden decline, hospital transfer or change in cognition.<\/li>\n<li>The ability to access directives electronically, share them with providers and incorporate them into electronic health records has gained importance.<\/li>\n<li>Families who have spoken about values, goals and preferences ahead of time experience less stress and confusion in crises.<\/li>\n<\/ul>\n<h3><strong>Why Keeping Them Updated Matters<\/strong><\/h3>\n<ul>\n<li>Preferences change. A document created a decade ago may no longer reflect someone\u2019s health, values or wishes.<\/li>\n<li>Make sure any named healthcare agent remains willing and reachable, and understands the older adult\u2019s values.<\/li>\n<li>When major changes occur\u2014new diagnosis, hospitalization, move to a senior community, cognitive decline\u2014take time to revisit the directive. Research shows that many long-term\u2010care residents have two or more changes in their orders while in residence. (<a href=\"https:\/\/www.jamda.com\/article\/S1525-8610%2824%2900512-7\/fulltext?utm_source=chatgpt.com\" target=\"_blank\" rel=\"noopener\">Jamda<\/a>)<\/li>\n<li>In Maryland, electronic advance directive registration was legislated in 2016; uptake remains modest. (<a href=\"https:\/\/mhcc.maryland.gov\/mhcc\/pages\/hit\/hit_advancedirectives\/documents\/hit_adv_directives_wkgrp.pdf?utm_source=chatgpt.com\" target=\"_blank\" rel=\"noopener\">Maryland Health Care Commission<\/a>)<\/li>\n<li>Share copies widely: give to primary care physician, cardiologist\/nephrologist, hospital admissions, living community, and keep a copy readily accessible at home.<\/li>\n<li>Remember state-specific requirements: signatures, witness or notarization, and how documents are stored or accessed in emergency situations.<\/li>\n<\/ul>\n<h3><strong>Maryland-Specific Legal Considerations<\/strong><\/h3>\n<ul>\n<li>In Maryland, advanced directives and a durable power of attorney for health care are recognized under law (see Md. Code Ann., Health-General \u00a7 5-601 et seq.).<\/li>\n<li>Electronic advance directives: A workgroup report from the Maryland Health Care Commission noted that despite legislative changes over several years, only approximately 2,500 Marylanders had created electronic advance directives via certified vendors as of the time of the report. (<a href=\"https:\/\/mhcc.maryland.gov\/mhcc\/pages\/hit\/hit_advancedirectives\/documents\/hit_adv_directives_wkgrp.pdf?utm_source=chatgpt.com\" target=\"_blank\" rel=\"noopener\">Maryland Health Care Commission<\/a>)<\/li>\n<li>Remember that older adults living in assisted-living or long-term-care facilities may need to review facility policies and ensure the directive is in the facility record and honored during transitions.<\/li>\n<li>While not unique to Maryland, families should check for updates to state registration systems and hospitals\u2019 acceptance of completed forms\u2014especially given recent pandemic-era shifts in care settings.<\/li>\n<li>Ask your bank if they accept your Power of Attorney (POA). Some state laws do allow financial institutions to require additional documentation, such as an affidavit (sworn statement) by your agent. But generally, banks must, by law, accept a POA that is validly made. A few exceptions do exist. For example, if the bank believes in good faith that your agent doesn&#8217;t have the authority to perform the act requested, or if the bank is aware of a report that your agent might be exploiting or abusing you, the bank doesn&#8217;t have to accept the document. Banks are wary of identity theft, scams, and elder abuse, and this wariness can take the form of roadblocks when your agent tries to use your POA to access your accounts. Banks might also stop short of outright refusing to recognize a POA, but their reluctance can take the form of equally inconvenient tactics\u2014like requiring several rounds of internal reviews, during which your agent&#8217;s hands are tied.<\/li>\n<li>You can make several different types of POAs in Maryland. In particular, many estate plans include two POAs: a financial POA, which allows someone to handle your financial or business matters, and a medical POA, which allows someone to make medical decisions on your behalf. (In Maryland, this medical POA is combined with a living will into a single document called an &#8220;advance directive.&#8221;) In most estate plans, these POAs are what are known as &#8220;durable&#8221; POAs, which means that they retain their effectiveness even after you&#8217;re incapacitated. It&#8217;s a good idea for most people to create these two documents, as they help plan for the unexpected.<\/li>\n<\/ul>\n<h3><strong>How to Start or Refresh the Conversation:<\/strong><\/h3>\n<ul>\n<li>Choose a calm, non-crisis moment to talk: perhaps after a doctor\u2019s appointment, at home or during a family visit.<\/li>\n<li>Ask open questions: \u201cWhat does quality of life look like to you? What kinds of treatments would you want or not want if you couldn\u2019t speak for yourself?\u201d<\/li>\n<li>Identify who they want as their agent\/decision-maker and make sure that person is willing and informed.<\/li>\n<li>Document the directive: sign, witness or notarize per Maryland law; scan or copy into healthcare records.<\/li>\n<li>Distribute copies and talk to providers: primary care, specialists, hospital, assisted-living facility.<\/li>\n<li>Review annually or after major health changes. Encourage the named agent and family to keep communication open and revisits regular.<\/li>\n<\/ul>\n<h4><strong>Conclusion<\/strong><\/h4>\n<p>Advanced directives are more than legal forms\u2014they\u2019re an individual\u2019s voice carried forward. By creating or refreshing these documents now\u2014especially in the post-COVID-19 era with the virus still in circulation and with Maryland-specific requirements in mind\u2014families give loved ones the gift of control and themselves the gift of clarity and peace of mind. If your family is facing senior-care transitions, hospital discharge, or selection of a community in the Baltimore region, our CarePatrol team is here to support you in navigating these important conversations and documents.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Works Cited<br \/>\n<\/strong>Jones, Adrienne L., Abigail J. Moss, and Lauren D. Harris-Kojetin. \u201cUse of Advance Directives in Long-term Care Populations.\u201d <em>NCHS Data Brief No. 54<\/em>, Jan. 2011.<\/p>\n<p>Daaleman, Thomas P., et al. \u201cAdvance Care Planning in Nursing Homes and Assisted Living: A Review.\u201d <em>PMC<\/em>, 2009.<\/p>\n<p>\u201cAdvance Directives Workgroup Report.\u201d <em>Maryland Health Care Commission<\/em>, 2021.<br \/>\nWong, H.J., et al. \u201cAdvance Directives Change Frequently in Nursing Home Residents.\u201d <em>Journal of the American Medical Directors Association<\/em>, vol. 25, no. 1, 2024.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>When we help families with senior care decisions, one of the most important conversations we encourage is about advanced directives. These are documents that give older adults a voice in their care when they can\u2019t speak for themselves. At CarePatrol of Baltimore we view advanced directives not as heavy paperwork but as empowerment\u2014preserving dignity, guiding&hellip;<\/p>\n","protected":false},"author":210,"featured_media":8200,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[10,57,24,12,11,1],"tags":[63,25,26,22,28,29,30,20,16,61,39,17],"class_list":["post-8820","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-caring-for-seniors","category-financial-resources","category-maryland-specific-resources","category-owner-voices","category-resources-information","category-uncategorized","tag-advanced-directives","tag-aging","tag-aging-well","tag-assisted-living","tag-care-advisor","tag-caregiver","tag-caregiver-support","tag-carepatrol-baltimore","tag-paula-sotir","tag-planning","tag-senior-care","tag-senior-living"],"acf":[],"_links":{"self":[{"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/posts\/8820","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/users\/210"}],"replies":[{"embeddable":true,"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/comments?post=8820"}],"version-history":[{"count":1,"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/posts\/8820\/revisions"}],"predecessor-version":[{"id":8821,"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/posts\/8820\/revisions\/8821"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/media\/8200"}],"wp:attachment":[{"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/media?parent=8820"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/categories?post=8820"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/carepatrol.com\/baltimore\/wp-json\/wp\/v2\/tags?post=8820"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}