An advance health care directive does two jobs. It names the person who makes medical decisions when you cannot speak for yourself, and it records your wishes about treatment at the end of life.
California publishes a statutory form for free and you can complete it yourself this afternoon. I would rather you did that than have nothing.
The agent matters more than the checkboxes
No document anticipates the actual situation. There will be a decision nobody wrote down, made at 2 a.m., with incomplete information. What carries you through that is the person, not the paperwork.
Pick someone who can be assertive with a physician, who can be reached, and who can follow your wishes rather than their own. That last one eliminates more well-meaning family members than people expect.
Executing it in California
Sign it in front of either two qualified witnesses or a notary. Your health care agent cannot witness it, and your treating provider cannot serve as your agent. If you live in a skilled nursing facility, there is an additional witnessing requirement involving a patient advocate or ombudsman.
We include a directive in every package and notarize it at the signing appointment, along with the HIPAA authorization that lets your agent actually see the records they are being asked to make decisions about.
A directive in a drawer is worthless
Give a copy to your agent, your primary care physician, and your alternate agent. Photograph it and keep the image on your phone. Hospitals cannot follow a document they have never seen, and nobody drives home to look for a binder during an emergency.
What to actually say in it
The form asks about prolonging life, relief from pain, organ donation, and burial or cremation wishes. Be specific where you have a real preference and leave the rest to your agent's judgment rather than trying to script every scenario.
Then have the conversation. Tell your agent what you would and would not want, out loud, in ordinary words. That five-minute talk does more work than any checkbox on the form.
“My own directive says one sentence beyond the standard language, about what I consider a life worth prolonging. My sister has read it. If she ever needs it, she will not be guessing at what I meant.”
Delia Vasquez-HartKeeping it current
- Redo it after a divorce, since an ex-spouse named as agent is a problem nobody wants to discover in an ICU.
- Redo it if your agent moves far away or becomes ill themselves.
- Revisit it after a serious diagnosis, when your preferences may genuinely change.
- Otherwise, a look every five years is plenty.
Questions we get asked
Is it the same as a living will?
California folded that concept into the advance health care directive. One document does both the agent appointment and the treatment instructions.
Will my directive be honored in another state?
Generally yes, though the details vary. If you spend significant time in another state, ask about executing that state's form as well.
Can my agent overrule what I wrote?
Your written instructions govern where they are clear. Your agent fills the gaps, which in practice is most of what happens.
Does the hospital keep it on file?
Only if you give it to them. Bring a copy to your next appointment and ask them to scan it into your chart.
Download California's statutory form today if you have nothing in place, fill it in, and get it witnessed or notarized. Then bring it to the consultation and we will make sure it lines up with the rest of the plan.