Is the Advance Health Care Directive different from a Durable Power of Attorney for Health Care?
The Advance Health Care Directive (AHCD) is a product of a California law enacted in July 2000.
It replaced the Durable Power of Attorney for Health Care (DPAHC) and the Natural Death Act Declaration. If you completed one of these forms prior to July 2000, they are still valid.
Why should I complete an Advance Health Care Directive?
People of all ages may have an unexpected injury or illness. Sometimes these patients cannot speak for themselves.
Having an Advance Health Care Directive assures that your doctor knows your wishes. They will know what kind of care you want and who you want to make decisions on your behalf.
Does this mean only one person can decide for me? What if I want others involved?
Often many family members are involved in decision-making. Most of the time, that works well. But sometimes people disagree about the best course of action.
It is best to name just one person as the agent and one as a backup. You can also say if there is someone who you do not want to make decisions for you.
But I thought the doctors made all those life-and-death decisions anyway?
Doctors tell you about your medical condition. They present different treatment options and possible results, but you make the decisions.
What if something happens to me and no form has been completed?
If you are not able to speak for yourself, the doctor and health care team will turn to one or more family members or friends.
The most appropriate decision-maker is the one with a close, caring relationship with you. This is someone who is aware of your values and beliefs and is willing and able to make the needed decisions.
My “values and beliefs?” But I haven’t talked with anyone about these!
That’s why it is a good idea to talk with family or close friends.
They should know what’s important to you regarding quality of life and how you would want to spend your last days and weeks. This will help your loved ones make the best possible decisions on your behalf.
If your agent doesn’t know your wishes, then he or she will decide based on what they believe is in your best interest.
What if I don’t want to appoint an agent or don’t have one to appoint?
You do not have to appoint an agent.
You can still complete the Instructions for Health Care portion of the Advance Health Care Directive form. This will provide your doctors with information to guide your care.
What kinds of things can I write in my Instructions for Health Care?
You can share your preferences about several end-of-life choices like:
- Accepting or refusing life-sustaining treatment like CPR, feeding tubes or breathing machines
- Receiving pain medication
- Making organ donations
- Indicating your main doctor for providing your care
- Other things that express your wishes and values
If I appoint an agent, what can that person do?
Your agent will make all decisions for you, just like you would if you could. They can:
- Choose your doctor and where you will receive your care
- Speak with your health care team
- Review your medical record and allow its release
- Accept or reject all medical treatments
- Make arrangements for you when you die
You should instruct your agent on these matters so he or she knows how to decide for you. The more you tell your agent the better.
When does my agent make decisions for me?
Usually, the agent makes decisions only if you’ve lost the ability to understand things or communicate clearly. If you want, your agent can speak on your behalf at any time, even when you are still capable of making your own decisions.
You can also appoint a "temporary" agent.
For example, if you suddenly become ill, you can tell your doctor if there is someone else you want to make decisions for you. This verbal instruction is as legal as a written one.
Are there other oral instructions that don’t involve a written form?
Yes. You can give health care instructions orally to any person at any time, and it is considered valid.
All health care providers must document your wishes in your medical record. But it is often easier to follow your written instructions.
Can I make up my own form or use one from another state?
Yes. That’s why this law is so flexible. Any type of form is legal if it includes:
- Your signature and date
- The signature of two qualified witnesses
- The signature of the patient advocate or ombudsman if you reside in a skilled nursing facility; these signatures, however, must include special wording
Sounds difficult. Do I need an attorney to help with this?
No. Completing an Advance Health Care Directive isn’t difficult. You do not need an attorney.
The most important part is talking to your loved ones. Without that conversation, the best form in the world may not be helpful.
OK, I’ll talk to them. But what should I do with the form after I complete it?
Make copies for all those who are close to you. Take one to your doctor to discuss and ask that it be included in your medical record.
Take one to your local hospital so if you enter the emergency room it will already have your Advance Health Care Directive.
Photocopied forms are just as valid as the original. And be sure to keep a copy for yourself in a visible, easy-to-find location — not locked up in a drawer.
What if I change my mind?
You can revoke your form (or your oral instructions) at any time.
Also, it’s a good idea to retrieve old forms and replace them with new ones.
Do doctors or hospitals require a patient to have an Advance Health Care Directive form?
No, they cannot require you to complete one.
But doctors and hospitals should have information available about the form and your right to make health care decisions.
