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Advance Care Planning FAQs

What is advance care planning?

Advance care planning is the process of making your health care decisions now in case you are unable to speak for yourself in the future due to an injury or serious illness. You can put your health care decisions into a document called an advance directive.

What is an Advance Health Care Directive (AHCD)?

An advance directive is a legal document which states the types of health care you want to receive if you are unable to make health care decisions for yourself. An advance directive states who you have chosen to be your health care agent – the person who will make health care decisions for you if you cannot speak for yourself.

Who should have an advance directive?

Everyone over 18 years of age should have an advance directive. An advance directive is important for healthy people because a healthy person could have a sudden unexpected health crisis and an advance directive would tell their loved ones and medical providers what types of medical care the person would and would not want. For a person who has a health condition, an advance directive is important because it states what is meaningful to that person about his or her quality of life, describes personal goals, and states what types of medical care he or she would want if the health condition changes.

What are the different types of advance directives?

Cottage Health provides the My Care advance directive to patients and community members. However, you may also use other legal advance directives, such as Five Wishes or the California Advance Health Care Directive.

What is a health care agent?

A health care agent is the person you choose to make health care decisions for you if you’re unable to speak for yourself. It’s important you discuss your health care decisions with your health care agent so that he or she understands, honors, and advocates for your decisions.

What types of decisions does a health care agent make?

You can indicate on your My Care Advance Directive the types of decisions your health care agent can make. These decisions could include:

  • Choosing your doctors and where you’ll receive care
  • Speaking with your medical providers
  • Deciding about tests, medicine, and surgery you could have
  • Planning for your medical care in California or another state
  • Reviewing and releasing your medical record
  • Planning for care in a nursing home or residential care facility
  • Making arrangements if you die

Who should I choose to be my health care agent?

Your health care agent can be a family member, friend or someone who:

  • Is 18 years or older
  • Knows you well
  • Agrees to accept this responsibility
  • Can be trusted to honor your wishes and values
  • Can make difficult decisions in stressful situations
  • Can be calm and think clearly when talking with your medical providers, family, and friends
  • Can be contacted easily by your medical providers

Your health care agent cannot be:

  • Your doctor
  • Someone who works at the hospital, clinic, or facility where you receive medical care, unless he or she is a family member or registered domestic partner

Can I have more than one person be my health care agent?

You can have only one person be your main health care agent. You can also choose an alternate health care agent who would only act if your main health care agent was unable or unavailable.

What if I change my mind about who I chose to be my health care agent?

You can change your health care agent at any time. You would need to update your advance directive and let your medical providers and loved ones know about this change.

What happens if I do not have a health care agent?

If you do not have a health care agent, your medical providers will rely upon your family members to decide upon the types of medical care you will receive. During stressful situations, this responsibility can be difficult on family members as they may be upset or disagree about decisions. Choosing a health care agent and discussing your health care decisions with him or her before you are injured or become seriously ill can provide relief and comfort to your family knowing that they do not have to make these decisions unprepared.

If you do not have a person you want to be your health care agent, it’s very important that you give a detailed description of your health care decisions in your advance directive. This detailed description will help your medical providers to understand and honor your decisions.

When does my health care agent make decisions for me?

Typically, your health care agent only makes health care decisions for you if you’re unable to speak for yourself. However, you can choose for your health care agent to make health care choices for you even if you are able to decide or speak for yourself.

Who needs to sign my advance directive in order for it to be legal?

You can choose either:

  • Two witnesses: One of your witnesses cannot be related to you (by blood, marriage, or adoption) and cannot be entitled to any part of your estate.
  • Notary Public: You must sign your advance directive when you are with the Notary Public.

If you are a patient in a skilled nursing facility, the patient advocate or ombudsman must also sign the document.

Who do I give copies of my advance directive to?

It’s important you provide a copy of your advance directive to Cottage Health and your medical providers. Cottage Health and any other medical providers will put your advance directive in your medical record.

If you have never been a patient of Cottage Health, Cottage Health will open up a new medical record for you and file your advance directive. If you become injured or seriously ill and go to Cottage Health, we will then have your advance directive accessible and will honor your health care decisions.

You should also provide copies to your loved ones and close friends. Some people also give a copy to their attorney and their faith community.

Be sure to keep copies for yourself at home where you can find them.

What is a POLST?

POLST stands for Physicians Orders for Life Sustaining Treatment. The POLST is a medical order which is typically used for patients who are seriously ill and states what kind of medical treatment a patient wants at the end of his or her life. This medical order must be signed by the patient and his or her physician, physician assistant, or nurse practitioner. The POLST is printed on pink paper and is placed in both a patient’s medical record and in a location in the patient’s home in which it would be visible to paramedics.

Who can my family speak with if they disagree about my advance directive?

Your family can request a Bioethics consult if they have disagreements, concerns or questions about the advance directive. Cottage Health’s Bioethics team is composed of a variety of health care professionals who will meet with the family, evaluate the situation, refer to your advance directive, and help your family with difficult decisions.

What is the End-of-Life Option Act and can I ask for aid-in-dying in my advance directive?

The End of Life Option Act is a California law that permits terminally ill adult patients with capacity to make medical decisions to be prescribed an aid-in-dying medication if the patient meets certain medical conditions and has authorizations.

An advance directive is a legal document that describes your personal health care decisions and states who you have chosen to be your health care agent.

Including your wish to use an aid-in-dying medication in your advance directive does not meet the requirements of the law. Your health care agent cannot request the aid-in-dying drug for you. You must meet the requirements applicable to this law.

You can learn more about the End of Life Option Act by contacting Compassion & Choices at 1(800)247-7421 or speak with your physician for more information.