If you became ill or injured and were unable to speak for yourself, would your loved ones know what kind of medical treatment you want? Would your family members and doctors be legally bound to carry out your wishes?
Without a valid document directing your health care, your wishes for medical treatment may not be known or honored. In an extreme case, your family members could end up in court, arguing over what’s best for you. In California, you can avoid outcomes like these by preparing a legal document called an Advance Health Care Directive.
If you've decided it's time to prepare documents directing your health care, congratulations. It may be challenging to think about the kinds of medical treatment you do or do not want at the end of life, but your completed forms are almost guaranteed to bring peace of mind to you and your loved ones.
To get started, you'll need the right forms to fill out. In California, that means obtaining an Advance Health Care Directive form.
Which Advance Directive Form Is Best?
You have several options for choosing health care forms in California. You can use the Advance Directive form published by the state, but you are not required to do so. more...
A health care agent is the person you name to make medical decisions for you if you are unable to speak for yourself. Some states use a different name for a health care agent, such as “proxy,” “representative,” or “attorney in fact.” California uses the term “health care agent.” You will name this person when you make your Advance Health Care Directive.
What Your Health Care Agent Can Do
If you can’t communicate because of a serious illness or injury, your health care agent is legally authorized to step in and carry out your wishes for medical care, making any necessary treatment decisions along the way. Your agent will have the sole legal authority to speak for you, taking into account all that he or she knows about your desires for treatment and your personal beliefs. Your agent is not required to consult family members before making decisions on your behalf, unless your Advance Health Care Directive explicitly requires that.
You can make a living will without a lawyer’s help. In fact, most states have designed their health care forms -- called Advance Health Care Directives in California -- with the specific intention that you will complete them yourself. Usually, you’ll need to consult a health care professional or an attorney only if there is something about your forms that you don’t understand.
How to Make Your Own Health Care Documents
Though you’re not likely to need professional help, you do need to take certain steps to ensure that your health care documents are legally valid. Each state has its own rules for creating health care documents; you’ll want to be sure you find and complete the right forms for your state. After your forms are filled out, you must finalize them correctly, including signing them in front of witnesses or a notary public, according to your state’s laws.
You can find the forms and rules for California using the links below.
When You May Want Professional Help
There are a few circumstances in which it makes good sense to make your health care documents with the help of a health care professional or estate planning lawyer.
Some states have established databases, usually called “registries,” where you can file your Living Will or Advance Directive. (If your state has a registry, you'll find a link to it at the end of this article.) Other states recommend a privately owned, national registry called the U.S. Living Will Registry. These systems provide central locations that medical professionals can consult to determine whether patients have made documents directing their health care.
Using a registry can increase the likelihood that your critical health care wishes will be found and followed when needed -- but there are other steps you should take to make your health care wishes known.
The Best Way to Make Your Health Care Wishes Known
After you've made a document directing your health care, the first thing to do is talk with the person you’ve named as your health care representative, often called your “agent.” more...
A DNR order, short for "do not resuscitate order," alerts emergency personnel that you do not wish to receive cardiopulonary resuscitation (CPR) in the event of a medical emergency. It is a medical order that must be signed by a doctor.
DNR orders are used primarily by people who are already critically ill and feel strongly that they do not want life-prolonging treatment when close to death. If you do not have a DNR order, emergency medical personnel must use all available measures, no matter how invasive, to save your life.
Getting a DNR order in the hospital. When you are admitted to a hospital, your doctor can add a DNR order to your medical record. This may happen in a number of ways:
A POLST form is a document that tells health care professionals what kind of medical treatments you do or do not wish to receive at the end of your life. POLST is short for “Physician Orders for Life-Sustaining Treatment,” though the document may go by a different name in your state.
How POLST Forms Work
A POLST form is a medical order that a doctor or other approved health care professional may make for you if you are:
nearing the end of your life, and
admitted to a hospital or enter another health care setting, such as hospice.
The POLST form gives directions to medical providers about life-sustaining treatments, such as CPR (cardiopulmonary resuscitation), intubation, and feeding tubes. If you move from one health care setting to another, you POLST form will travel with you.
To be valid, health care provider who helps you make the POLST must sign the form and place it in your medical records. It will be printed on brightly colored paper so it can’t easily be overlooked.
Why You Still Need a Living Will
Even though a POLST form addresses many of the same issues covered by a DNR order and a living will, it is not a complete substitute for a properly prepared set of advance directives.
You cannot, for example, use a POLST form to name a health care agent to carry out your health care wishes. For that, you need a durable power of attorney for health care. Nor can you make a POLST form in advance -- while you are healthy -- to specify your treatment wishes for the future. To do that, you need a living will.
How to Get a POLST Form
POLSTs are not yet available in all states. Where they are used, they may go by another name, such as POST (Physician Orders for Scope of Treatment), MOLST (Medical Orders for Life-Sustaining Treatment), or COLST (Clinician Orders for Life-Sustaining Treatment).
If California offers a POLST or similar form, you can find out what it is called and learn more about it by clicking the link below. If California is not on this list, see the end of this article for more information.
A Mental Health Care Directive is a document that describes your wishes for care and treatment if you have a psychiatric emergency. It takes effect only during times when you are unable to communicate or make your own decisions. A Mental Health Care Directive is sometimes called an Advance Mental Health Care Directive or a Psychiatric Advance Directive.
Besides stating your treatment preferences, a mental health care directive usually names a trusted person to speak on your behalf. This person, often called your agent, works with mental health care providers to ensure you get the kind of care you want.
How Mental Health Care Directives Differ from Standard Advance Directives
A typical Advance Health Care Directive or Living Will gives instructions about end-of-life health care. But a Mental Health Care Directive may be used during periods of serious mental illness at any stage of your life. It focuses on treatment concerns that arise during psychiatric crises, such as hospitalization, medications, doctors, and therapists. more...