Advance Health Care Directives

A Gift to Families

An advance health care directive tells your family and doctor what you want done if you can’t make decisions for yourself.  Your family and doctor don’t have to guess what you would have wanted.  What would be the highest priority?  It might be to be pain free, or to not be on a ventilator, or to have everything done to keep you alive as long as possible.  This isn’t just for older people, all adults should make one.  After all, young people can be injured in accidents that leave them unable to speak.

Three Parts

An advance health care directive has three parts.  In the first part you name a person to be your agent (and alternates in case the agent is not available).  The agent can legally make health care decisions for you and is called a Durable Power of Attorney for Health Care.  In the second part, you state in detail the treatments you would want, or would not want, and under what circumstances—things like feeding tubes, ventilators and what to do if your heart and breathing stop.  In the third part you can say if you want to be an organ or tissue donor.

Choosing an Agent

The person you choose as an agent must be 18 years old, and someone who knows you well and who will honor your wishes, even if they are different from yours.  A husband or wife is not automatically recognized as a patient’s spokesperson in California.  The agent may be a family member, a friend, or even an attorney, but caregivers in a facility cannot be agents for residents.  Agents may choose a doctor, hospital, skilled facility or hospice for you.  The agent may also accept or refuse treatments on your behalf, and consent to organ donation.

Making it Legal

An advance health care directive does not need to be prepared by an attorney, but it must be signed and dated in front of two witnesses (who are not the agent or alternate) or it can be notarized.   There is no official, standard form.  One web site where you can get advance directives in several languages is www.codaalliance.org.

When complete, you should make sure your doctor, loved ones and agent all have copies.  The original should be kept in a safe place and a copy should go with you to the hospital.  Experts recommend that an advance directive be updated at least every 10 years, in the event of a divorce, or if the agent is unable to act.  The directive is valid forever unless you revoke it or state in the directive the date on which you want it to expire.

This article was originally published in Pathways Residential Care Journal - Issue 3.  To download this issue in PDF format, or past issues, visit our newsletter archives online at www.pathwayshealth.org/publications.