Advance Care Planning & End of Life Decisions - PIH Health - Whittier, CA

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Advance Care Planning & End of Life Decisions

Advance Care Planning is for everyone, not just the elderly. According to the Coalition for Compassionate Care of California the advance care planning discussion starts at age 18 and continues for the rest of your life. As we go through life we may face medical crises or serious injuries and may not have the ability to express our healthcare wishes.

The advance care planning process allows you to:

  • Explore your healthcare wishes including identifying someone who would act on your behalf if you are unable to make your wishes known
  • Express your healthcare wishes by completing an Advance Healthcare Directive which can be updated at any time as your life and wishes change

Advance care planning allows PIH Health to:

  • Honor your healthcare wishes. When the time comes, your family and healthcare providers will use the Advance Healthcare Directive to guide the decision making process on your behalf.

Advance Healthcare Directives

An Advance Healthcare Directives is legal document that expresses a patient’s healthcare wishes and identifies a person to act on the patient’s behalf if they are unable to communicate their wishes. This document should be completed by anyone 18 years or older and can be updated as the patient’s life and wishes change. This document has to be witnessed or notarized.

Download an Advance Care Planning Guide that includes an Advance Healthcare Directive:

Advance Healthcare Directives in California

Each state sets up its own types of advance directives and the rules about how to use them. In California, the legal form of advance directive is called the California Advance Health-Care Directive. It was formerly known as the Durable Power of Attorney for Health Care. If you created advance directives in another state and have since moved to California, you’ll need to review your previous documents with a trusted local resource such as a hospital, your medical provider, a social worker or attorney to make sure your wishes are fulfilled.

PIH Health Helps You With Advance Healthcare Directives

When you’re admitted to a PIH Health hospital, you’ll receive a written explanation of advance healthcare directives, asked if you have one and given an opportunity to complete the form. For more information about advance healthcare directives at PIH Health, ask a member of your healthcare team (physician, nurse or social worker).

Frequently Asked Questions About Advance Healthcare Directives

Explore this information about advance healthcare directives to find out what’s best for you and your family or caregiver.

Why are advance healthcare directives important?

Planning and writing your advance healthcare directive helps you control your healthcare. Although spoken wishes may be used, it’s better to write down what you want. Spoken wishes can be misunderstood or ignored. Without an advance healthcare directive, certain treatments may be given, even if you don’t want them.

If you don’t have an advance healthcare directive, family members or caregivers will need to make treatment decisions for you and may allow treatments you would not have preferred. Making such decisions can be very hard for the people in your caregiver network, especially if they’re not prepared. When you talk with your loved ones about your preferences and create an advance healthcare directive, you help them provide the care you desire and better cope with your illness or injury.

Please be sure to discuss and share your wishes with your healthcare agent, family and healthcare providers.

Who can make an advance healthcare directive?

Anyone 18 years of age or older, of sound mind and legally competent can make an advance healthcare directive.

What is the California Advance Healthcare Directive—formerly the Durable Power of Attorney for Health Care (DPACH)?

An Advance Healthcare Directive is a legal document that expresses a patient’s healthcare wishes and identifies a person to act on the patient’s behalf if they are unable to communicate their wishes. This document should be completed by anyone 18 years or older and can be updated as the patient’s life and wishes change. This document has to be witnessed or notarized.

The advance healthcare directive allows you to appoint another person—known as a healthcare agent—to make a wide range of healthcare decisions for you if you’re not capable of making them for yourself, or immediately if you specify within your advance healthcare directive.

A Healthcare Agent is someone you select who is 18 years or older, a family member or a friend, and is able to honor your healthcare wishes. The healthcare agent cannot be your healthcare provider (physician or member of the hospital staff).

Consider the following in selecting a Healthcare Agent:

  • Someone you trust, like a family member or friend
  • Someone who knows you well and is able to honor and respect your wishes
  • Someone who is able to handle difficult decisions in a calm manner
  • Someone who is able to communicate with your healthcare team, and family or significant others

Common decisions that the Healthcare Agent may make include:

  • Deciding where you will receive care and who will provide it
  • Deciding if blood and/or blood products will be provided to you
  • Choosing medical treatments that may affect your quality of life
  • Speaking with the healthcare team regarding your treatment options
  • Speaking with the healthcare team regarding discharge options and the initiation of funeral or burial arrangements after you die
  • Ensuring that your healthcare wishes are honored by the healthcare team and family

How do I make an advance healthcare directive?

You can formulate an advance healthcare directive yourself. You do not need a lawyer to complete these forms. Within the advance healthcare directive when selecting a Power of Attorney for Health Care, two people must witness your signature, or it must be acknowledged before a notary public. The forms themselves describe who may or may not serve as a witness.

You can also formulate an advance healthcare directive during any hospital admission at PIH Health at no cost. For more information please talk to your healthcare team (physician, nurse or social worker).

What happens if I don’t have an advance healthcare directive?

You will receive medical care regardless of whether or not you have an advance healthcare directive. However, if you have an advance healthcare directive, there may be a greater chance you’ll receive the type of care and treatment you want.

If you can’t speak for yourself and don’t have an advance healthcare directive, a physician will look to your family members for your treatment decisions. If PIH Health can’t find any family to act on your behalf, they may ask the courts to appoint a person (guardian) who will make decisions for you.

Where should I keep my advance healthcare directive?

First, make several copies of your advance healthcare directive. Give a copy to your healthcare agent, family members, healthcare providers, important people in your caregiver network and your lawyer, if you have one. Ask your physician to make your advance healthcare directive part of your permanent medical record. Any legible copy of an advance healthcare directive is an acceptable document.

Next, find a safe place where you and others can easily locate your copy—but don’t use a safe deposit box. A copy of your advance healthcare directive must be available while your care is under way or it can’t be used as a guide for your treatment.


Where can I find more information about advance healthcare directives?

Check with the California Hospital Association and the California Coalition for Compassionate Care, or download our Advance Care Planning Guide that include an Advance Healthcare Directive.

Physician Orders for Life-Sustaining Treatment (POLST)

POLST is a physician order that helps give seriously ill patients more control over their end-of-life care. This distinctive bright pink form is signed by both doctor and patient. POLST specifies the types of medical treatment a patient wishes to receive toward the end of life. That means POLST can prevent unwanted or medically ineffective treatment, reduce anxiety for patients and families and help ensure patient wishes are honored.

Frequently Asked Questions About POLST

Is a POLST form required by law?

Filling out a POLST form is completely voluntary. However, California law requires that physician orders in a POLST form be followed by healthcare providers.

Who should have a POLST form?

Doctors say that seriously ill patients and those with chronic, progressive illness should have a POLST. Adults and children may have a POLST. There is no age limit.

Does the POLST form replace traditional advance healthcare directives?

No. The POLST form complements an advance healthcare directive and is not intended to replace that document. An advance healthcare directive is still necessary to appoint a legal healthcare agent; it’s recommended for all adults, regardless of their health status.

If someone has a POLST form and an advance healthcare directive that conflict, which takes precedence?

If there is a conflict between the documents, the more recent document would be followed.

Who completes the POLST form?

A healthcare professional—usually a doctor, nurse or social worker—completes the form after having a conversation with the patient to understand his/her wishes and goals of care. For it to be valid, both a doctor and the patient must sign the POLST form.

What if my loved one can no longer communicate her/his wishes for care?

A healthcare professional can complete the POLST form based on family members’ understanding of their loved one’s wishes. The appointed decision maker can then sign the POLST form on behalf of their loved one.

What happens to my POLST form after it is completed and signed?

  • The original POLST form, on bright pink paper, stays with you at all times.
  • In a hospital, nursing home, or assisted living facility, the form will be in your medical record or file.
  • If at home, place your form in a visible location so it can be found easily by emergency medical personnel – usually on a table near your bed, or on the refrigerator.

Can I change my POLST form?

Yes, you can change your POLST form at any time should your preferences change. It is a good idea to review the decisions on your POLST form when any of the following occur:

  • You are transferred from one setting to another, for example you go from your home to the hospital, or you are discharged from the hospital to a nursing home
  • There is a change in your overall health, or you are diagnosed with an illness
  • Your treatment preferences change for any reason

What happens if I don’t have a POLST form?

Without a POLST form, emergency medical personnel, nurses and doctors would not know your treatment wishes. You will most likely receive all possible treatments, whether you want them or not. Talking about your treatment choices with your loved ones and doctor before a problem occurs can guide them and help ensure you get the care you want.

Are faxed copies and/or photocopies valid? Must pink paper be used?

Faxed copies and photocopies are valid. Ultra Pink paper is used to distinguish the form from other forms in the patient’s record; however, the form will be honored on any color paper.

How can I get a POLST form?

Patients can request the form from their healthcare provider. It is important to discuss your goals of treatment with your healthcare provider so you can decide if POLST is right for you, and how to document your decisions appropriately on the form. The form can also be found at capolst.org, along with other helpful resources.

What if I travel to another state – will my POLST form be valid?

The California POLST form is valid in California. If you are traveling to another state, it is a good idea to take both your Advance Directive and your POLST form with you. Both documents, even if not legally binding, will help healthcare providers know your wishes.


How can I find out more about POLST?

Talk to your doctor, or visit the California POLST website.

Download the POLST Form [PDF] in ENGLISH or SPANISH.

Contact Us

Our Patient Services representatives can help you find information and solve problems. We also connect you with PIH Health doctors and services.

8 am – 5 pm
Monday through Friday
562.947.8478 Ext. 82199

During your hospital admission a Social Worker can assist you to formulate an Advance Healthcare Directive.

 

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