How to Fill Out an Advance Directive in Maine: Step-by-Step Guide

What You Are Actually Filling Out

Maine does not use separate living will and healthcare proxy forms. Under the Uniform Health Care Decisions Act (Title 18-C, Section 5-803), everything goes into a single document called an advance health care directive. This combined form has multiple parts, and you can complete all of them or only the sections that apply to your situation.

Hospital-provided forms from systems like MaineHealth or Northern Light Health use the same statutory template — but they come without instructions for signing, filing, or coordinating with other medical orders.

Part 1: Designate Your Healthcare Agent

This is where you name the person who will make medical decisions if you cannot communicate. Maine uses the term "health care agent" rather than "healthcare proxy" or "medical power of attorney," though all three mean the same thing.

Choose carefully. Your agent should be someone who:

• Understands your values about medical treatment
• Can handle high-pressure conversations with doctors
• Lives close enough to be physically available during a crisis (or can travel quickly)

Name an alternate agent. If your primary agent is unavailable or unwilling to serve, the alternate steps in automatically.

Restriction you need to know: Under Maine law, an owner, operator, or employee of a residential long-term care facility where you receive care cannot serve as your agent — unless they are related to you by blood, marriage, or adoption.

Part 2: Write Your Individual Instructions (Living Will)

This section records your treatment preferences. Be as specific as possible. The more detail you provide, the less guesswork your agent and medical team face.

Address these situations:

• Terminal condition: Do you want life-sustaining treatment if your illness is incurable and death is expected within six months?
• Permanent unconsciousness: What are your wishes if you are in a persistent vegetative state with no reasonable chance of recovery?
• Artificial nutrition and hydration: Do you want feeding tubes or IV fluids if you cannot eat or drink on your own?
• Pain management: Do you prioritize comfort-focused care, even if it may hasten death?

You can also include preferences for specific interventions — mechanical ventilation, dialysis, blood transfusions, antibiotics for infections.

Part 3: Organ and Tissue Donation

You can document your wishes about anatomical gifts directly in the directive. Options include donating all organs and tissues, limiting donation to specific organs, donating for research purposes, or declining donation entirely.

If you have already registered through the Maine Bureau of Motor Vehicles or the National Donate Life Registry at RegisterMe.org, the most recently executed document governs. Make sure your directive and registry selections match.

Part 4: Burial and Cremation Authority

Maine allows you to grant your healthcare agent authority over the disposition of your remains. However, there is a critical legal distinction: if you include this provision, the document must be notarized under 22 M.R.S. Section 2843-A. The standard two-witness signing ceremony is not sufficient for burial/cremation authority.

If you do not include this section, decisions about your remains fall to the statutory next-of-kin hierarchy.

Part 5: Psychiatric Advance Instructions

Maine permits you to include mental health treatment preferences in the same directive. This is designed for individuals with fluctuating psychiatric conditions who want to pre-consent to or refuse specific treatments during future periods of incapacity.

You can specify preferred inpatient facilities, authorize or refuse specific psychotropic medications, and set guidelines for emergency transport.

The Signing Ceremony

This is where most mistakes happen. Maine has strict requirements:

1. Sign by hand — digital and electronic signatures are prohibited for healthcare powers of attorney
2. Two adult witnesses must sign in your presence, and you must sign in theirs — all three people in the same room
3. Your healthcare agent cannot be a witness — neither can your alternate agent
4. Notary is optional for standard healthcare directives, but required if you include burial/cremation authority

Schedule a specific time for this. Trying to complete the signing casually — at a family dinner, for instance — often results in missing a witness or unclear signatures.

After You Sign: Distribution

Maine does not maintain a state advance directive registry. You are responsible for distributing copies to:

• Your designated healthcare agent and alternate agent
• Your primary care physician
• Your local hospital (to be added to your electronic medical records)
• Any long-term care facility where you reside
• A trusted family member who is not your agent

Keep the original in an accessible location at home — not in a safe deposit box, which may be inaccessible during a medical emergency.

One More Thing: Your Directive Cannot Stop Paramedics

Even a perfectly executed advance directive will not prevent emergency medical technicians from performing CPR or intubation. Maine EMS personnel are legally required to initiate full resuscitative efforts unless they are physically shown a signed POLST form or Comfort Care/DNR order. If you want to prevent unwanted emergency interventions, you need a separate medical order signed by your physician.

The Maine Advance Directive & Living Will Kit includes the complete statutory form, a signing-day checklist, and a POLST/DNR reference guide so you can coordinate all your documents in one sitting.

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