Explore this information about advance healthcare directives to find out what’s best for you and your family or caregiver.
Why are advance healthcare directives important?
Planning and writing your advance healthcare directive helps you remain in control of your healthcare. Although spoken wishes may be used, it’s best to express what you do or don’t want in writing. Spoken wishes can be misunderstood or ignored. Without an advance healthcare directive, If you are unable to communicate with healthcare providers certain treatments may be given even if you don’t want them.
If you don’t have an advance healthcare directive, family members or caregivers will be asked to make treatment decisions without any guidance from you and may allow treatments you would not have preferred. Making such decisions can be very hard for the people in your caregiver network, especially if they are not prepared. When you talk with your loved ones about your preferences and create an advance healthcare directive, you help them understand what is important to you so they can provide the care you desire and better cope with your illness or injury.
It is important to discuss and share your wishes with your healthcare agent, family and healthcare providers.
Who can make an advance healthcare directive?
Anyone 18 years of age or older, of sound mind and legally competent can make an advance healthcare directive.
What is the California Advance Healthcare Directive—formerly the Durable Power of Attorney for Health Care (DPACH)?
An advance healthcare directive is a legal document that expresses a patient’s healthcare wishes and identifies a person to temporarily act on the patient’s behalf for any length of time they are unable to communicate their wishes. Once a patient regains consciousness/capacity, they will resume making their own healthcare decisions. This document should be completed by anyone 18 years or older and can be updated as the patient’s life and wishes change. The State of California requires this document to be witnessed or notarized.
The advance healthcare directive allows you to appoint another person-- known as a healthcare agent-- to temporarily make a wide range of healthcare decisions for you, during any period of time, you’re unable to make them for yourself. The advance healthcare directive also allows you to give your healthcare agent immediate authority to make decisions for you if you wish.
A Healthcare Agent is a trusted person you select who is 18 years or older, a family member or a friend, and is able to honor your healthcare wishes. The healthcare agent cannot be your healthcare provider (physician or member of the hospital staff).
Consider the following in selecting a Healthcare Agent:
- Someone you trust, like a family member or friend
- Someone who knows you well and is able to honor and respect your wishes
- Someone who is able to handle difficult decisions in a calm manner
- Someone who is able to communicate with your healthcare team, and family or significant others
Common decisions that the Healthcare Agent may need to make include:
- Deciding where you will receive care and who will provide it
- Deciding if blood and/or blood products will be provided to you
- Choosing medical treatments that may affect your quality of life
- Speaking with the healthcare team regarding your treatment options
- Ensuring that your healthcare wishes are honored by the healthcare team and family
- Speaking with the healthcare team regarding discharge options
- The initiation of funeral or burial arrangements after you die
How do I make an advance healthcare directive?
You can formulate an advance healthcare directive yourself. You do not need a lawyer to complete these forms. The State of California requires that two people must witness your signature or it must be acknowledged before a notary public. The forms provide direction on who may or may not serve as a witness.
You can also formulate an advance healthcare directive during any hospital admission at PIH Health at no cost. For more information, please talk to your healthcare team (physician/nurse practitioner, nurse, chaplain or social worker).
What happens if I don’t have an advance healthcare directive?
You will receive medical care regardless of whether or not you have an advance healthcare directive. However, if you have an advance healthcare directive, there may be a greater chance you’ll receive the type of care and treatment you want.
If you can’t speak for yourself and don’t have an advance healthcare directive, a physician will look to your family members for your treatment decisions. If PIH Health can’t find any family to act on your behalf, they may ask the courts to appoint a person (guardian) who will make decisions for you.
Where should I keep my advance healthcare directive?
First, make several copies of your advance healthcare directive. Give a copy to your healthcare agent, family members, healthcare providers, important people in your caregiver network and your lawyer, if you have one. Ask your physician to make your advance healthcare directive part of your permanent medical record. Any legible copy of an advance healthcare directive is an acceptable document.
Next, find a safe place where you and others can easily locate your copy—but don’t use a safe deposit box. A copy of your advance healthcare directive must be available while your care is under way or it can’t be used as a guide for your treatment.
Where can I find more information about advance healthcare directives?
Check with the California Coalition for Compassionate Care, or download our Advance Care Planning Guide that include an Advance Healthcare Directive.
