Advance Directive MD

02/04/2026

More from my podcast episode with end-of-life doula Traci Arieli

01/31/2026

More from my interview with Comforting Closure.

01/28/2026

I recently had the opportunity to record a podcast episode “how to talk to your doctor about your advance directive” with host Traci Arieli, PMP, CEOLD of Comforting Closure.

I thought it was such a great topic that I synthesized it into a simple article. Please share with anyone who may need to see this.

Anyone who is dealing with:

➡️significant chronic illness (history of heart attacks, strokes, diabetes)
➡️ multiple hospitalizations in the past 12 months
➡️ an early dementia diagnosis
➡️ cancer or other serious illness
➡️ a mental health disorder that may put them at risk of hospitalization

…or just you, your spouse, your parents

By Eleanor Tanno, M.D. Many people want to talk to their doctor about creating an advance directive. This is understandable since the process can seem daunting. For many, discussing their wishes with a trusted, medical professional brings reassurance and comfort. Your primary care physician (P*P) is...

01/28/2026

I had the pleasure of recording a podcast episode “how to talk to your doctor about your advance directive”

01/25/2026

Ask any physician, patients tell us things that sear into our minds. A recent patient said this to me about her end-of-life planning:

“I want quality not existence.”

This five word statement holds so much wisdom.

It is like a North Star to guide her medical care. These words convey so much more than a check list of life sustaining interventions.

This is what I teach about advance directives. They do not need to be big and scary. They do not need to be full of legal or medical jargon.

They just need to be simple statements that embody your values. These statements guide the person you designate as your medical decision maker, the person who becomes your voice to the medical team.

It’s actually quite beautiful when done in a meaningful way.

01/24/2026

I had an interesting advance directive conversation over the holidays. I know,
I know…who talks about these things at family gatherings!

A family member suddenly, and seemingly stressed, said “I need to contact our attorney about changing our living will.”

Of course my head turned and my ears perked up. I asked her why the urgency.
She said “I don’t want to be an organ donor. I’m afraid.”

Now, organ donation is a wonderful gift, and I find that people seem to be slightly polarized here. Either they feel strongly for or against being a donor.

I am not here to debate the value of being an organ donor; I have seen many patients who have been recipients of a life-saving organ gift. However, if someone feels strongly about their medical wishes, that is personal and commendable. It is also critical that they put it in writing in the form of an advance directive so that their wishes are known.

I encouraged this family member to make the update to her documents to reflect her strong opinion.

Of note, the fact that she had this conversation with the family is probably the most important part of the process. We heard the passion in her voice and her medical wishes were clear. There was no confusion for me: she does not want to be an organ donor and now I am clear on that.

To me, this is an example of a “pearl” that comes out of these conversations. People use tone, words, and body language to express strong and memorable opinions.

The written advance directive is the cherry on top!

The 15 minute conversation that can prevent a lifetime of guilt By Eleanor Tanno, M.D. When someone is critically ill and in the hospital, physicians usually first consult their family members about the type of medical care to provide. If a spouse is not available, adult children are typically the n...

04/16/2025

🎶 To tune of “My Favorite Things” for National Healthcare Decisions Day🎶

[verse 1]
Proxies on pages and signatures witnessed
Discussions with fam'lies in case there is sickness
Agreement if there are many offsprings
These are a few of my favorite things

[verse 2]
Copies in places where people can find them
Knowledge of wishes that prevents the mayhem
Prepared for any and all that health brings
These are a few of my favorite things

[chorus]
When the stroke hits, when the heart stings
When you're feeling bad,
An Advance Directive steps right into place
And then your care is iron-clad

02/24/2025

How exciting! I was appointed as a Director to the Board of Directors for the Maryland Academy of Family Physicans this past weekend!

Thank you to my mentors who got me here, especially Dr. Kathryn Hart, MD, FAAFP who encouraged me to apply to the board.

Additionally, thank you to Dr. Mozella Williams, MD MBA who once told me the way to keep more primary care doctors in Maryland is to train them in Maryland. She also kept me in the advocacy loop over the years.

What an honor!

I am specifically here to represent private practice physicians, physician entrepreneurs, and physicians in non clinical roles with my research role.

This group of driven physicians is ready to advocate for family physicians in Maryland!

01/26/2025

Success story! One of my patients is a woman in her 70s, a former race car driver, and a divorcee. Her adult children live many states away and both are busy with their own children.

For the past few years at her annual Medicare wellness visit, I’ve asked her if she has created an advance directive. Every year, she says no. I’ve encouraged her to at least think about who she’d want as her medical decision maker.

Like so many of my patients, she states she doesn’t want to be a burden.

Translation: she is worried about naming her children as her medical decision makers because it is a lot of responsibility and she feels guilty about this.

I hear this so often.

I remind patients that by *not* having these conversations about end-of-life preferences, one can actually become *more* of a burden. When families do not know what to do, they are torn, and often err on the side of more aggressive medical interventions. This leads to more anguish and guilt - “did I make the right decision for my mom?”

But, I said this is a success story, right?

Well, this year at her annual Medicare visit, I asked her whether she had made an advance directive. With a beaming, proud smile, she said “I did it!” I matched her smile! She said a weight was lifted off her shoulders.

In primary care, we don’t have a lot of time with patients. We do have time to plant seeds, though. And that’s what I did here - planted a seed the grew and grew. It grew so big it could no longer just be an idea. It was an idea that took root and called for action!

So here we are, moving the dial on creating advance directives. Just one person at a time, but for that one person and her family, this could make all the difference.

01/24/2025

Myth or fact: you need a physician or attorney to create an advance directive.

This may surprise you, but this is a myth!

In most states, you can complete an advance directive on your own!

But how?

Just download your state advance directive by googling “advance directive [your state]” and you can generally easily locate your state form. If you can’t find it, you can also use the “Five Wishes” document as a legal advance directive in most states. Easy peasy.

Taking that first step is the hardest part!

And don’t agonize over filling it out once you get it! Just do your best, and know that you can always update it! Just remember, most important part of the process is the conversation you have with your loved ones who will be left to care for you.

Here is Maryland’s advance directive. Easy to find, free, and no need for a physician or attorney. You don’t even need it notarized!

12/12/2024

When I was a first year resident seeing patients in the Intensive Care Unit, I was immediately struck by how many families were completely unprepared to make tough medical decisions for their loved ones.

Their anguish was almost palpable.

But then I noticed something.

Families who had previously had even a *single* conversation with their loved ones about end-of-life preferences seemed to be dramatically less stressed.

I thought, more people need to be having these conversations. It turns out, only 36% of people have an advance directive.

However, while having an advance directive as part of an estate planning package was helpful, I saw that the document often lacked the nuances we needed to make confident decisions in a medical setting.

I made it a mission to educate people on making informed, meaningful advance directives. I teach courses on the subject and I recently launched my online course “create an advance directive with a physician.”

And now, I have the distinct honor of being invited to join the Advisory Board for The Washington Home. This incredible charitable foundation provides funds to a wide variety of causes that support seniors in the Washington, D.C. region.

Together, we are working to spread the word about advance directives. Through their website, they offer my course to the people they serve.

The Board of Directors and Staff of The Washington Home are pleased to welcome the newest member of our Advisory Board, Eleanor Tanno, M.D. of Advance Directive MD. With her extensive expertise in the care and well-being of older adults, Dr. Tanno is an influential leader creating awareness and resources to help older adults prepare for their medical care later in life. We appreciate her time and perspective to support TWH grant initiatives for our community.

11/21/2024

I have a really exciting announcement.

This week, I was appointed by Montgomery County Executive Marc Elrich as a commissioner to the County Commission on Aging.

As a family physician who cares for hundreds of seniors, I hear their unique struggles daily. Among them, the struggles of aging in place, medication costs, rising housing costs, and loneliness. I hear about more and more physicians not accepting Medicare and the difficulties for seniors to find physicians.

These are complex issues, and the Commission is the dedicated team to tackle them.

I am proud to join this team and looking forward to a great two year term.