You have the right to help make decisions about your own health and well-being. Advance Directives are spoken or written documents and information about the medical care you prefer. With these documents, you can make decisions when you are able to think clearly about your wishes, use good judgment, and talk to others.
What are Advance Directives?
Advance Directives can apply to any medical decision, such as the treatments you want, and if you want to donate organs. There are many types of Advance Directives, and each state has rules about how to use them.
Why are Advance Directives important?
Planning and writing your Advance Directive helps you control your health care. Although spoken wishes may be used, it is better to have your wishes written down. Spoken wishes can be misunderstood, or not followed. Without this plan, certain treatments may be given even if you do not want them. If you do not have an Advance Directive, family members or caregivers will make treatment decisions for you. Your spouse, adult children, or parents may allow certain treatments. This can be very hard for them, especially if they are not prepared. Having your Advance Directive ready may make your illness or injury easier for them to cope with.
Who can make Advance Directives?
If you are 18 years of age or older and of “sound mind” and legally competent, you can make an Advance Directive.
What is a Durable Power of Attorney for Health Care? (DPACH)
The power of attorney for healthcare is a form that allows you to appoint another person (a “health care agent”) to make healthcare decisions for you if you are not capable of making them for yourself. When you complete this form, you give authority to your healthcare agent to make a wide range of decisions for you. A power of attorney for healthcare does not go into effect until you are unable to make decisions for yourself.
What is the role of my health care agent or my health care power of attorney?
An agent selected by you has the authority to make any and all decisions you would make if you were able, including: choosing your doctor/other healthcare provider and where you will receive your care, speaking with your health care team on your condition and treatment options, reviewing the medical record and authorizing its releases when needed, and accepting or refusing medical treatments, including artificial nutrition and hydration and resuscitation attempts.
How do I make an Advance Directive?
You do not need a lawyer to complete these forms. However, for a Durable Power of Attorney for Health Care, two people must witness your signature, or it must be acknowledged before a notary public. The forms themselves describe who may or may not be a witness.
What happens if I don’t make an Advance Directive?
You will receive medical care regardless of whether or not you have an Advance Directive. However, there may be a greater chance you will receive the types of care and treatments that you want if you have an Advance Directive. If you cannot speak for yourself and do not have an Advance Directive, a physician will look to your family members for your treatment decisions. If the medical center is unable to locate 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 Directive?
You should make several copies of your Advance Directive. A legible copy of an Advance Directive is acceptable. Find a safe place where you and others can easily find your copy. (Do not keep it in a safe deposit box.) Your family members and your lawyer, if you have one, should know you have made an Advance Directive and have a copy. You should also ask your physician to make your Advance Directive part of your permanent medical record. Without a copy of your Advance Directive, it cannot be used as a guide for your treatment.
Outside Information Sources:
California Hospital Association
California Coalition for Compassionate Care
Physician Orders for Life-Sustaining Treatment (POLST)
What is the POLST form?
POLST is a physician order that helps give seriously ill patients more control over their end-of-life care. Produced on a distinctive bright pink form signed by both the doctor and patients, POLST specifies the types of medical treatment that a patient wished to receive towards the end of life. As a result, POLST can prevent unwanted or medically ineffective treatment, reduce patient and family suffering, and help ensure the patients’ wishes are honored.
Is POLST required by law?
Filling out a POLST form is entirely voluntary, but California law requires that the physician orders in a POLST form be followed by health care providers.
Who should have a POLST form?
Doctors say that seriously ill patients and those who have a significant chance of dying in the next year should have POLST.
Does the POLST form replace traditional Advance Directives?
The POLST form complements an Advance Directive and is not intended to replace that document. An Advance Directive is still necessary to appoint a legal health care decision maker, and is recommended for all adults, regardless of their health status.
If someone has a POLST form and an Advance Directive that conflict, which takes precedence?
If there is a conflict between the documents, the more recent document would be followed.
Who completes the POLST form?
A health care professional, usually a doctor, nurse, or social worker, completes the form after having a conversation with the patient to understand his/her wishes and goals of care. Both a doctor and the patient must sign the POLST form in order for it to be valid.
How can I find out more about POLST?
Talk to your doctor, or visit the California POLST website at www.caPOLST.org
Outside Information Source:
Coalition for Compassionate Care of California