PAMF Health Blog

Be Well, Be Well Informed

Advance Health Care Directive: Plan for the Unexpected

Posted on Feb 20, 2013

None of us would ever want to be incapacitated to the extent that we could not make decisions affecting our well-being. Unfortunately, for some of us, that day may come.

For most individuals, that time comes later in life, but for others it happens much too early.

What sort of medical situations could cause such a scenario? You could be incapacitated by accident or illness, such a serious head injury, heart attack, stroke, Alzheimer’s disease, meningitis or many other illnesses, diseases, and injuries.

To help in these situations, California has established an Advance Health Care Directive — sometimes referred to as a “living will” — that instructs physicians as to your wishes for medical treatment if you were to be incapacitated and unable to make decisions on your own.

Under California law, this form allows you to name an agent, granting that person power of attorney, to make health care decisions on your behalf should you become incapacitated.

Your agent should be a trusted person, either a family member or a friend, who has your best interests at heart, understands your wishes and will act accordingly. Two alternates may also be named.

The directive must be dated and executed in the presence of, and then signed by, two witnesses or a notary. A witness cannot be your physician, any of his or her employees or any employee of a care facility. At least one of the witnesses cannot be related to you by blood, marriage or adoption and must not be entitled to any part of your estate upon your death.

The most important function of the directive is to permit health care providers to either prolong or not prolong your life and to keep you pain free according to your wishes. You may also state your desire for organ donation, if you so choose.

What’s POLST Got to Do With It?

A physician’s order for life-sustaining treatment (POLST) complements an AHCD. This document, signed by both you and your doctor, details the type of medical treatment you want at the end of your life. Find out more about POLST or ask your doctor about this form.

It is important to make such decisions when you are of healthy mind and body. Don’t put your loved ones in the difficult position of guessing what type of care you would want in an end-of-life event.

All adults age 18 and older need advance directives. Talk to your physician if you have any questions. You can find more information, including answers to frequently asked questions, and a free downloadable Advance Health Care Directive form (English and Spanish) on the Palo Alto Medical Foundation website:

Advance Health Care Directive Form — English/Spanish form (.pdf)

AHCD FAQs (.pdf)

ACHD Terminology (.pdf)

 Learn more about AHCD and POLST:

Your Guide to POLST (Physician Orders for Life-Sustaining Treatment) -California’s resource page for consumers

Advance Health Care Directive (PAMF’s information and resources page for AHCDs)

Coalition for Compassionate Care of California (POLST, AHCD, DNR)

Terry Hollenbeck, M.D. contributed to this blog post and is an urgent care physician at the Palo Alto Medical Foundation Santa Cruz in Scotts Valley.

Terry Hollenback, M.D.

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