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Later Life Planning

California Advance Care Directives

There are several different terms (and forms) that have been used to express the kind of medical care we want to have if we're not able to make  decisions or to state our wishes directly. "Living will" and "Durable Power of Attorney for Health Care" (DPAHC) are older examples. California law has been rewritten to update all these under the term "Advance Health Care Directive". (If you did have a DPAHC, it's still valid unless it was written in 1992 or earlier.)

It's a very good idea for every adult to have an Advance Health Care Directive and to choose a Healthcare Agent. These are not just for seniors - adventurous 18-year-olds, parents of young children,  middle-aged people in the "sandwich generation", and the rest of us need these, too. Below are resources that will help you decide what matters to you, and help you record your wishes.

California hospitals, nursing facilities, and long-term care facilities in California are now using the POLST forms to record patients' treatment preferences. As explained in the two boxes below, these are not quite the same thing as an Advance Health Care Directive (although they may overlap).

CA Forms and Worksheets for Advance Directives

When you're ready to start making a record of your preferences and values, these free online resources will walk you through the steps to create an Advance Health Care Directive.

The Nolo Press guide to preparing an advance care directive discusses the many questions and options in its sections for "Naming Your Health Care Agent", "Granting Specific Powers to Your Agent", "Stating Your Wishes for Organ Donation", and "Specifying Your Health Care Wishes".

Prepare for Your Care (Regents of the University of California) offers this ​Advance Health Care Directive worksheet for CA residents. Print, fill in, and share copies with your medical care agent, health care team, and / or your family. The second link below leads to CA forms in Armenian, Chinese, Farsi, Khmer, Korean, Russian, Tagalog, & Vietnamese (besides English and Spanish) and to forms in use by other U.S. states.

 

The Chinese-American Coalition for Compassionate Care has also prepared an easy Chinese / English guide to preparing an Advance Health Care Directive.

The Thinking Ahead guide takes a think - plan - do approach, and was developed by several agencies in cooperation with the Coalition for Compassionate Care in California.

What to do After Completing the Advance Care Directive

Once the Advance Care Directive is made, be sure to:

  1. discuss it with your Health Care Agent and your loved ones;
  2. keep it somewhere that is easy to find in an emergency (and tell your loved ones where it is);
  3. update it for major life events;
  4. stay in touch with your Health Care Agent.

POLST Form

The POLST (Physician Orders for Life-Sustaining Treatment) form talks about what you want now and in the immediate future. It is intended for healthcare workers to use in circumstances when you are not able to state your wishes. The Coalition for Compassionate Care for California defines it as " a physician order signed by both a doctor and patient that specifies the types of medical treatment that a patient wishes to receive toward the end of life." It lays out in specific medical terms the circumstances in which you do / do not wish to receive lifesaving medical procedures like CPR, a feeding tube, or being placed on a ventilator. It is completely voluntary - and can be particularly useful for communicating your wishes under emergency situations or with unfamiliar health care teams.

A POLST form should be filled out by qualified healthcare personnel and the patient together. (If the patient cannot participate, it can be completed by qualified healthcare personnel working with the family and/or Health Care Agent.)

It can be changed - in fact, it should be updated regularly, especially as your condition progresses.

See the resources below for more information. The last resource includes links to download .pdf POLST forms in Armenian, Chinese, Farsi, Hmong, Japanese, Korean, Pashto, Russian, Spanish, Tagalog & Vietnamese.

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