Almost all of your discussions with patients regarding advance care planning will revolve around two basic pieces of paper: an advance directive or a POST (Physician Orders for Scope of Treatment; also called POLST in some states). Both have different functions, should be brought up at different times in care, and can work cohesively together if a patient has both filled out. Below, the National POLST Paradigm has helped delineate the difference between the two.
Advance directives are more likely to be brought up in an out-patient setting when patients are healthy; the most important part of the document is that it appoints a legal power of attorney in the event a patient can no longer speak for themselves. It is extremely important in your discussions with patients that you stress how crucial it is for them to express their wishes to their POA, and they choose an individual who would carry through with their health wishes.
POST forms are more likely to be addressed in an in-patient setting or in the process of a terminal illness discussion, because its most important piece is that it provides legal documentation of specific medical care wishes such as comfort level, IVs/nutrition, antibiotics, etc.