What is an Advance Health Care Directive?  It is a formal way to write down and document your wishes about the care you wish to receive in the event that you are unable to speak for yourself sometime in the future.  To quote the State of California Office of the Attorney General:

An “advance health care directive” lets your physician, family and friends know your health care preferences, including the types of special treatment you want or don’t want at the end of life, your desire for diagnostic testing, surgical procedures, cardiopulmonary resuscitation and organ donation.

By considering your options early, you can ensure the quality of life that is important to you and avoid having your family “guess” your wishes or having to make critical medical care decisions for you under stress or in emotional turmoil.

The decisions you make in this regard should be based on your own values and beliefs, and in conjunction with your loved ones; especially the one(s) whom you plan to make responsible for speaking on your behalf in the event that you are incapacitated or otherwise unable to speak for yourself. Discussing this subject with these individuals will help you crystallize your thoughts.  Also, very importantly, it relieves them from the burden of having to guess what you would want done for you!

The California State Attorney General’s Office also provides a useful Advance Health Care Directive Checklist. We include some extracts here:

The material prepared for this checklist is intended as informational only and not as legal advice. “If you are unsure of your options or have questions, we suggest that you talk with your physician, your lawyer and other trusted advisors.”

    • Gather Information For Decision Making. Your physician is a good place to start for understanding your options on health care treatment at the end of life. In addition, many organizations have information that may be useful.
    • Discuss Your End-of-Life Decisions With Key People. Talk about your decisions with your family, physician and others who are close to you. Some questions to consider for discussion:
      • What is important to you when you are dying?
      • Are there specific medical treatments you especially want or do not want?
      • When you are dying, do you want to be in a nursing home, hospital or at home?
      • What are the options in Palliative Care/Pain Management and Hospice Care?
    • Prepare Your Advance Care Directive Form. Under state law, you have a legal right to express your health care wishes and to have them considered in situations when you are unable to make these decisions yourself. 

While state law requires certain provisions to appear in your health care directive, there is no single form in use to document your wishes. 

A wide array of resources are available on advance health care directives, including FAQs provided by health and hospice care providers such as the California Medical Association.

  • Designate Person To Carry out Wishes. Select who should handle your health care choices and discuss the matter with them. You could name a spouse, relative or other agent.
  • Inform Key People Of Your Preferences. Notify your doctor, family and close friends about your end-of-life preferences. Keep a copy of your signed and completed advance health care directive safe and accessible. This will help ensure that your wishes will be known at the critical time and carried out. Give a copy of your form to:
    • The person you appoint as your agent and any alternate designated agents
    • Your physician
    • Your health care providers
    • The health care institution that is providing your care
    • Family members
    • Other responsible person who is likely to be called if there is a medical emergency

There are a number of ways to prepare an Advance Care Directive.  It is frequently one of the documents that make up a Living Trust or Estate Plan.  If you plan to set up such a Trust, you should consult your legal and financial advisors.  Several agencies and institutions provide forms that can be filled out, together with instructions.  We provide information on a few of them below, together with links to the documents —  with the caveat that this is by no means a complete list, and that you should review these and other options carefully before choosing the best one for you.

The Institute for Health Care Advancement provides a version of the Advanced Health Care Directive Form for California. As they say on their website, “This easy-to-read, easy-to-understand form was created for people with limited reading skills and skilled readers alike.”   Individuals and facilities are welcome to download, print, and use this directive. But the form is copyrighted by them you may not alter it in any way.  This document has been approved for use in California. But it may not apply in other states.  You may view or download the form here: California Advanced Health Care Directive Form

In addition, here are three other sources to investigate:

The California Hospital Association provides downloadable forms in English and Spanish.

The Hospice Services of Lake County CA provide a downloadable form

The Stanford University School of Medicine provides a downloadable form

Finally, we have one more recommendation.  Check out the Stanford Letter Project. It is a very interesting undertaking that might help you define more clearly what matters most to you!  As they state on their website:  “We are building a What-Matters- Most Letter Bank. This will be a national repository of What-Matters- Most Letters. Our goal is to collect 100,000 letters representative of a diverse population and make it available to anyone who wants to be guided by the population wisdom as they write their own What-Matters- Most Letters. “