How Advance Care Directives Work in California
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 terms and forms. California law has been rewritten to update all these and bring them together under the term "Advance Health Care Directive". (If you did have a DPAHC, it's still valid if written in 1993 or later.)
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 advanced care directives, too. This guide has links tor sources 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 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).
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.
What to Do After Completing an Advance Care Directive
Don't stop yet! Once the Advance Care Directive is made, be sure to:
The POLST (Physician Orders for Life-Sustaining Treatment) form talks about what you want right now, and in the immediate future. It is intended for healthcare workers to use when you are in a hospital or care facility, and 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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