Lees Summit, MO Guide to Planning Future Medical Decisions

Advance healthcare directives let adults explain their medical wishes and identify who may speak for them if illness or injury prevents them from making decisions. For residents of Lees Summit, MO, these documents can reduce confusion during emergencies and help family members, physicians, and healthcare facilities understand the person’s preferences.

An advance directive is not only for older adults or people with serious diagnoses. A car accident, sudden illness, surgery complication, or temporary loss of consciousness can create the same need at any age.

What is an advance healthcare directive?

An advance healthcare directive is a written record that provides instructions about healthcare decisions or appoints someone to make those decisions. Missouri law recognizes both a healthcare power of attorney and a declaration, such as a living will, as forms of advance healthcare directive. ([revisor.mo.gov](https://revisor.mo.gov/main/OneSection.aspx?section=459.250&utm_source=openai))

The two parts often work together:

• Healthcare power of attorney: Names an agent to communicate with healthcare providers and make decisions when the patient cannot make or communicate informed choices.
• Living will or healthcare declaration: Describes preferences about life-prolonging procedures, particularly when a person is terminally ill or permanently unable to make decisions.

A directive can provide general guidance, specific instructions, or both. It may address artificial nutrition and hydration, ventilation, resuscitation, pain control, surgery, dialysis, organ donation, and other treatment questions.

What does a healthcare agent do?

A healthcare agent makes medical decisions based on the patient’s known wishes, values, and instructions. The agent does not automatically make financial decisions, manage bank accounts, or handle property. Those responsibilities usually require a separate financial power of attorney.

The person selected should be someone who can:

• Stay calm during a medical crisis
• Communicate clearly with doctors and nurses
• Make difficult decisions under pressure
• Respect the patient’s wishes, even when those wishes differ from the agent’s personal preferences
• Be available by telephone or in person when needed

A spouse or adult child may be a natural choice, but family relationship alone does not guarantee that someone is the right agent. It is also wise to name an alternate agent in case the first choice is unavailable, unwilling, or unable to serve.

When does the document take effect?

A healthcare power of attorney generally becomes useful when the patient lacks the ability to make or communicate healthcare decisions. The exact activation language depends on the document.

Missouri’s durable power of attorney law allows authority to continue despite the principal’s later incapacity. The document should clearly state that it is durable and should explain when the agent’s authority begins. ([revisor.mo.gov](https://www.revisor.mo.gov/main/OneSection.aspx?bid=22969&section=404.705&utm_source=openai))

Some documents require a medical determination of incapacity before the agent acts. Because wording matters, residents should read the activation provisions carefully rather than assuming every healthcare power of attorney works the same way.

Does Missouri require notarization or witnesses?

Execution requirements depend on the type of document and the wording used. Missouri statutes address declarations and durable powers of attorney separately, and the state provides statutory forms and directions for certain advance healthcare directives. ([revisor.mo.gov](https://www.revisor.mo.gov/main/OneChapterRng.aspx?tb1=459.010+to+459.055&utm_source=openai))

A document that is signed informally, missing required formalities, or unclear about the agent’s authority may create delays when it is needed. The safest approach is to follow the execution instructions for the specific form and preserve the original document.

Missouri law also recognizes electronic execution for certain written estate planning documents, including advance directives and healthcare powers of attorney, under requirements effective August 28, 2025. Because electronic signing rules can involve technical conditions, a digital document should not be assumed valid merely because it contains an electronic signature. ([revisor.mo.gov](https://www.revisor.mo.gov/main/OneSection.aspx?section=474.560&utm_source=openai))

What should the directive say?

The document should be specific enough to guide decisions but flexible enough to address medical circumstances that cannot be predicted. Useful topics include:

• Whether the person would want cardiopulmonary resuscitation in different situations
• Preferences concerning ventilators and other life-support measures
• Whether artificial nutrition or hydration should be used when recovery is unlikely
• Priorities concerning comfort, pain relief, and hospice care
• Religious, cultural, or personal considerations
• Who should receive medical information
• Whether the agent may make decisions about organ or tissue donation
• Where the person would prefer to receive care, if practical

Broad statements such as “do not use extraordinary measures” may be interpreted differently by different people. A conversation with a physician can help explain what various treatments involve and what outcomes may be realistic.

Where should copies be kept?

A signed directive is useful only if the people making decisions can find it. Copies should generally be provided to:

• The healthcare agent and alternate agent
• The primary physician
• Relevant specialists
• Close family members or trusted friends
• A hospital or long-term care facility, if requested
• The person’s electronic medical record, when that option is available

Keep the original in a location that is accessible during an emergency. Avoid placing it in a locked box that family members or medical personnel cannot open promptly.
Area households should also consider seasonal disruptions. Severe storms, power outages, winter travel conditions, or evacuation from a home can separate a person from paper records. A secure digital copy and a wallet card identifying the agent can provide useful backup, while protecting sensitive information from unnecessary exposure.
Missouri law provides that a copy of a healthcare power of attorney should become part of the patient’s medical record once the provider knows it exists and before acting under the agent’s decision. The agent generally has rights to receive relevant information and review medical records, subject to limits in the document and applicable law. ([revisor.mo.gov](https://revisor.mo.gov/main/OneSection.aspx?section=404.840&utm_source=openai))

Can an advance directive be changed or revoked?

Yes. A person who has decision-making capacity can usually update or revoke an advance directive. Changes should be made carefully, signed as required, and distributed to everyone who received the earlier version.
When a new directive replaces an old one, clearly state that prior documents are revoked if the form does not do so automatically. Tell the healthcare agent, family members, and medical providers about the change. Destroying an old copy may help prevent confusion, but it should not be the only step taken.
A verbal statement may also be significant in an emergency, but relying on oral instructions alone can lead to uncertainty. Written updates are generally easier for healthcare providers and family members to verify.

What is the difference between an advance directive and a do-not-resuscitate order?

An advance directive expresses future healthcare preferences and may appoint a decision-maker. A do-not-resuscitate order, or DNR, is a medical order concerning resuscitation if the person’s heart stops or breathing ceases.
A DNR is not the same as refusing all treatment. Someone may want CPR withheld but still want antibiotics, surgery, oxygen, hospitalization, or comfort-focused care. Conversely, an advance directive does not always function as an immediately visible medical order during an emergency.
People with serious or progressive conditions should discuss whether additional medical orders are appropriate and how those orders should be kept available.

Common misunderstandings to avoid

Several assumptions can create problems:

• “My family will automatically decide.” Family involvement does not guarantee that the preferred person will have clear authority.
• “My will covers medical decisions.” A will generally operates after death and does not replace a healthcare directive.
• “The agent can do whatever they want.” The agent must follow the patient’s instructions and applicable legal limits.
• “The document is permanent.” Directives can usually be revised as health conditions, relationships, or beliefs change.
• “A facility can require me to sign one.” Missouri law prohibits healthcare providers and facilities from requiring a person to execute a durable healthcare power of attorney as a condition of receiving care or admission. ([revisor.mo.gov](https://revisor.mo.gov/main/OneSection.aspx?section=404.835&utm_source=openai))

An advance healthcare directive works best when it is part of an ongoing conversation. Review it after a major diagnosis, marriage, divorce, death of an agent, change in personal beliefs, or move between states. The document should reflect current wishes and be easy for the right people to locate.