Advance Directives

Advance directives let you say ahead of time what kind of health care you want or do not want in a medical emergency.

Advance Directives Forms

Simple Forms

California Hospital Association Forms

Your rights as a patient

Your have legal rights when you go to a hospital, nursing home, doctor, or other medical caregiver. Usually these rights include:

  • The right to keep your medical records private.
  • The right to know what medical care your doctor recommends if you are sick or hurt.
  • The right to refuse all or part of any medical care you do not want.

Sometimes, because of a sickness or injury, you may not be able to let peopleknow your feelings about these rights. For that reason, you may wish to havea paper called an "advance directive." It tells your doctor and othercaregivers what you want if you need care when you are unable to speak for yourself.

Types of advance directives

There are two common types of advance directives. One is called a "living will." The other is called an "Advance Health-Care Directive."

Living will

In a living will, you say what health care you want or do not want in the eventyou have a medical emergency and are either mentally or physically not ableto speak for yourself. This is called a living will because it takes effectwhile you are still living.

It is important for you to show your living will to your doctor to be surethat your instructions are understood and can be followed. Give your doctora copy of your living will to put in your medical file. Also, let a familymember or a close friend know that you have a living will and where they can find it if needed.

Advance Health-care Directive

In an Advance Health-Care Directive, you pick another person to make health-caredecisions for you if you become incapable of making your own decisions or ifyou want someone else to make those decisions for you now even though you arestill capable. That person will make medical decisions for you when you areeither mentally or physically unable to speak for yourself.

This other person is called your "agent." Your agent can be a familymember, other relative, close friend, or another trusted person such as yourlawyer. If you prepare an Advance Health-Care Directive, you may want to nametwo people as your agents. The first person would be your primary agent; thesecond person would be your alternate agent. You may also name an alternateagent to act for you if your first choice is not willing, able, or reasonable available to make decisions for you.

Make sure your agents understand what care you do or do not want in a medicalemergency, and that they are willing to follow your wishes. If you want to,you can put directions for your care in an Advance Health-Care Directive, just as you would in a living will.

Advance directives and the law

Federal law requires hospitals, skilled nursing facilities, hospices, homehealth agencies and health maintenance organizations (HMOs) that serve personscovered by either Medicare or Medicaid to give them information about advancedirectives. The facility must tell you about your legal right to have an advance directive and to refuse any medical care you do not want.

Every state, the District of Columbia, and United States commonwealth orterritory has laws which let people have advance directives. However, thelaws are not the same in every state. If you spend a great deal of time ina state other than your home state, you may want your advance directive tomeet the laws of both states as much as it can. Or you may wish to have aseparate advance directive for each state where you think you might go formedical care.

While the laws are not the same in each state, the basic rule of doing whatthe patient wants is the same everywhere.

In most states, both a living will and an Advance Health-care Directive arepapers which must be signed by you and by two other adults (witnesses). Thesetwo adults must watch you sign the paper, and the paper must be dated atthe time you sign it.

Your state may have its own living will form which you can get from the officeof your state attorney general. The office telephone number is in the bluepages of your telephone directory. Community organizations may also haveforms which you can fill out and sign.

If you plan to write your own living will or Advance Health-care Directive,find out what the laws are in the state where you may be a patient. Afteryou know what the laws are, you are ready to start writing your advance directive.To help you decide what you want it to say, you may wish to talk with familymembers, close friends, your doctor, your lawyer, or another trusted personsuch as your minister.

Advance directives are not required

You do not have to prepare an advance directive if you do not want one. Ifyou do have one, you may change or cancel it at any time.

Any change or cancellation should be written, signed, dated, and witnessed.Copies of the changed advance directive should be given to your doctor andto others who have a copy of the old one. Before making any changes, findout what the state law says you must do when you change an advance directive.

If you wish to cancel or change an advance directive while you are in thehospital, you should tell your doctor, your family, and others who need toknow. If you are able to communicate, the doctor will generally follow yourdirections even when those directions are different from your living willor Advance Health-care Directive.

Why have an advance directive?

You may want to have an advance directive if:

  • You want to protect your right to make choices about your medical care that can affect your life;
  • You want your doctor or other caregiver to know the kind of medical care you want or don't want if you are too sick to speak for yourself;
  • You do not want your family and friends to make decisions about your care because you do not think they will follow your directions or you do not want to burden them.

Summary

An advance directive allows you to let others know your choices for healthcare or to name someone to make those choices for you if you are unable tospeak for yourself. You may say "yes" to life-prolonging treatmentyou want, or "no" to life-prolonging treatment you don't want.

Make sure that at least one person, such as your lawyer or a family member,knows that you have an advance directive and knows where you keep it. If youhave an Advance Health-care Directive, give a copy or the original to youragent. Keep a small card in your purse or wallet stating that you have an advancedirective, where to find it, and who your agents are--if you have named agents.

Because you might change your mind about what kind of medical treatment youwant as you get older, you should read your advance directive at least oncea year. If you make any changes, be sure to give copies of the changes to yourdoctor, agents, and others who need to know. Make sure the changes are witnessed.

Where to get more information

To learn more about advance directives in your area contact:

  • The state hospital association
  • The state medical society
  • Your local area agency on aging
  • The office of your state
  • Attorney general

For further information, call 1 (800) LLUMC-97.

Loma Linda University Medical Center Patient Relations Department
11234 Anderson Street
Loma Linda, CA 92354
Phone: (909) 558-4647
Fax: (909) 558-0312
Email: patientrelations@llu.edu

Loma Linda University East Campus Hospital
25333 Barton Road
Loma Linda, California 92354
Phone: (909) 558-6502