Advance Directive Delaware: What Disability Families Need to Know

Why an Advance Directive Matters When Your Child Turns 18

The day your child turns 18, every hospital, clinic, and specialist in Delaware treats them as an independent adult. Nemours Children's Health, ChristianaCare, and every other provider will stop sharing medical information with you — no phone updates, no appointment coordination, no treatment discussions — unless your adult child has signed a legal document authorizing it.

Delaware's Advance Health-Care Directive (AHCD), governed by 16 Del. C. Ch. 25 under the Uniform Health-Care Decisions Act, solves this. It lets your young adult name a healthcare agent (usually a parent) and spell out their treatment preferences in writing — all without going to court.

What a Delaware Advance Health-Care Directive Covers

An AHCD does two things in one document. First, it designates a healthcare agent who can make medical decisions when your adult child lacks capacity to make the relevant health-care decision, unless the directive provides otherwise. Second, it records living will preferences — the kind of care they want (or don't want) in specific medical situations.

For disability families, the healthcare agent designation is the critical piece. It means you can authorize treatments, review medical records, and coordinate with specialists during emergencies without waiting for a court order.

Delaware's Strict Witness Requirements

Under current 16 Del. C. § 2508, a power of attorney for health care must be in a record, signed by the young adult, and signed by one adult witness who reasonably believes the act is voluntary and knowing. The witness cannot be:

• The named agent
• The agent's spouse, domestic partner, or cohabitant
• If the young adult resides or receives care in a nursing home or long-term care facility, the facility's owner, operator, employee, or contractor

The witness must be present when the young adult signs the power of attorney or represents that it reflects their wishes. The statute permits real-time electronic or audio presence in the circumstances it specifies.

Notarization is not required by statute, but it is strongly recommended. A notary stamp creates a reliable record of mental competence at the time of signing, which matters if the directive is ever challenged.

The DMOST Form: A Companion Document

Delaware's Medical Orders for Scope of Treatment (DMOST) form works alongside the advance directive but serves a different purpose. While the AHCD records the young adult's general wishes and names an agent, the DMOST translates those wishes into specific medical orders that emergency responders and hospital staff follow in real time.

The DMOST is a physician-signed order, not a form the family completes alone. It covers decisions about CPR, mechanical ventilation, IV fluids, and hospital transfers. For young adults with complex medical needs, having both an AHCD and a DMOST ensures consistent care across providers and emergency situations.

The official Delaware advance directive form is available through the Division of Services for Aging and Adults with Physical Disabilities (DHSS/DSAAPD).

Capacity: Can Your Young Adult Sign One?

To execute a valid AHCD, the young adult must have capacity under Chapter 25: they must be willing and able to communicate a decision independently or with appropriate support and understand the nature and consequences of the health-care decision or instruction. To appoint an agent, they must recognize the agent's identity and understand the general nature of the relationship.

If there is genuine uncertainty about whether your child can understand the document, work with their physician or a disability-experienced attorney to assess capacity before the 18th birthday, not after a medical crisis forces the question.

How an Advance Directive Fits with Other Legal Tools

An AHCD handles healthcare decisions specifically. It does not cover finances, education, or everyday life choices. Most Delaware families pursuing a dignity-first transition plan pair it with:

• A Durable Power of Attorney (12 Del. C. Ch. 49A) for financial and property decisions
• A Supported Decision-Making Agreement (16 Del. C. Ch. 94A) for day-to-day support without removing any rights

Together, these three documents often eliminate the need for a Court of Chancery guardianship petition entirely. They cost a fraction of what guardianship proceedings run, and your young adult keeps their full civil rights.

The Timeline That Works

Execute the advance directive at least two months before the 18th birthday. Submit it to every healthcare provider — pediatrician, specialists, hospital systems — so their records departments have it processed before the legal transition hits. Waiting until after the birthday creates a gap where no one can legally speak for your child in a medical emergency.

If your family is navigating the full turning-18 transition in Delaware — healthcare directives, educational rights, financial planning, and guardianship alternatives — the Delaware Adult Guardianship & Alternatives Guide walks through every option with the specific forms, witness rules, and timelines that apply in your state.

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