One essential component of AD that many mistakenly overlook is that health care wishes should not be kept secret. Copies of the document should not be locked up; several should be distributed among family, health care providers, and significant others. Resistance can be expected with discussion of AD and ultimate decision making. A difficult task in life is learning to let go of life. Despite the numerous barriers presented, persistence and encouragement in AD discussion will hopefully result in improved completion rates. After all, it is an immense opportunity for individuals to say what matters most to them.