California Advance Health Care Directives


This post targets Californians specifically. If you have Advance Health Directives or your loved one executed in another state, you may want to also complete a California AHCD to ensure that you meet California’s legal requirements.


What is the Advanced Health Care Directive?(AHCD)
The AHCD allows you to do the following:

  • Appoint a health care agent – also known as the Durable Power of Attorney, or Attorney-in-fact. They have the legal authority to make health care decisions on your behalf, if you are not longer able to make decisions on your own.
  • Prepare Instructions for Health Care – You can write specific written instructions for your future health care in the event of any situation where you can no longer speak for yourself.

Who to choose as a health care agent
Obviously, this should be someone whom you trust, such as a spouse or other relative. There are restrictions, the agent CANNOT be:

  • Your supervising health care provider
  • Operator of a community or residential care facility
  • An employee of a residential, community or health care facility ,unless that person is a relative, spouse or co-worker.
  • You can choose someone else, if the first agent is unwilling or unable to make health care decisions for you

How much power to give to the health care agent?
You or your loved one is in control over how much power to give. Some of these include:

  • The right to select of discharge care providers or institutions
  • The right to refuse/consent treatment
  • Access medical records
  • Withdraw or withhold life-sustaining treatment
  • Upon death, you can permit/restrict organ donations, authorize an autopsy, and direct the disposition of your remains

Medical Bills
Your agent is not liable for any of your medical bills, unless they are legally responsible for your debts. However, they may be responsible for fees regarding the burial/cremation of your body if you have not made other arrangements.

Power over Finances
What the AHCD does not do is give your health care agent the authority to make financial decisions on your behalf, that is the Durable Power of Attorney.

Health care Instructions
You do not need to write out your health care instructions, but it’s a good idea in case your agent is unavailable in an emergency. It’s also a good reminder for your agent.You can find different standard forms or write one yourself. Usually, they specify instructions on medication,respirators, etc. In the event of an emergency, personnel may not be aware of your health care instructions. You may not want to be resuscitated.

If you have additional instructions that will not fit in the standard form that you receive, you can attach additional sheets. Be sure to sign and date each sheet and have them notarized.

Choosing a Primary Care Physician
You are allowed to choose a Primary Care Physician with the AHCD.

Age Requirements
Any California resident who is at least 18 years old and mentally competent can execute an AHCD. 2 qualified witnesses (same requirements as health care agent)or a notary public can sign the AHCD. No attorney is required.

What to do with a completed form
Here are a few suggestions:

  • The form should include your name, signature, date executed and signature of witnesses or notary public.
  • Keep original copy in a place where family and friends can locate it
  • Give copies to: primary doctor, all agents, family members and health care facilities where you are receiving care.
  • Put a card or note in wallet or purse stating that you have an AHCD
  • If you spend extended time in another state, you should complete advance directives there using that state’s forms and rules.
  • Bring copies to an institution or facility where you are being treated.

Where to get forms
You can make your own, but may find it easier to just get standardized forms. You can order a standardized AHCD kit for around $5.00 from the California Medical Association at 800-882-1262 or order from their website.

*credit: SCRC

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Elder Law: When Senior still has mental capacity

One important, yet complex and quite stressful aspect of caregiving is taking care of all of the legal issues regarding your loved one.My sister and I still have much to do in this department. Because we are dealing with both parents, this is a little tricky. My father is still mentally capable, he still maintains his status as the responsible party in his and my mother’s affairs. However, in the unfortunate event that my father passes before we are unable to establish a Power of Attorney, we could be in for a big headache.

Here are a few strategies to consider:

As mentioned above, my sister and I are still in the process of getting things in order. We have completed some tasks and still have others that we need to complete before time runs out.

Make sure to have the care receiver sign legal documents while he or she has the mental capacity to do so. We had our mother sign some of the paperwork while she was still able. However, my father has signed on her behalf for much more recent documents. It is important to establish a Power of Attorney as soon as possible. * See Power of Attorney later in this article.

What is a will? A will is a legal document that states where or to whom a person’s assets will be left to after his or her death. The person signing the will must have the mental capacity to do so. Wills can be hand-written by an individual who must sign and date it. There is also legal software that you can purchase to easily write up a will. Finally, you can go the traditional route and have an attorney prepare a will in accordance with your state law. Assets in a will include any possessions in the person’s name only. Beneficiaries will receive assets under the will after death.

The assets included in the will are given out after a court-supervised process called a probate. Probate transfers a person’s assets to whomever is specified in the will. Probate court charges fees for this service which are taken directly from the assets before they are given to the recipient.

A person can change their will whenever he/she feels the need to do so. The will does not need to be disclosed to anyone and it should be kept in a safe place.

If the will isn’t completed before a person still has the mental capacity to do so, the community assets (assets acquired during a marriage), will be given to the spouse. If there is no spouse, community assets will be distributed to the children. Separate assets will be distributed to the spouse and other relatives. If for some reason, there is no family, the assets will be given to the state.

Many times, you local senior advocacy center can provide these services free of charge

A revocable living trust is a legal document that allows a person to specify what will happen to their assets while they are still living, incapacitated or after they die. The trust is labeled “living” because it is made while the person is still alive. The revocable living trust can be changed or revoked at any time as long as the person still has the capacity.

The trust is set up in a way that a person’s assets listed in the trust are “owned” by the trust. The grantor, (individual with assets in the trust) can act as trustee and manage his or her own trust or have an outside person or organization act as a trustee.

A successor trustee should be chosen to manage the trust if the original trustee is incapacitated. More than one successor trustee should be chosen in case the first loses capacity. Since the assets of the grantor are in trust, it avoids probate court.

Advanced Health Care Directive
An advanced health care directive allows persons to make their care decisions before they become incapable of making these decisions on their own.

In the directive, procedures and treatments are listed that a person can include or refuse in any situation. Another term used for the Advanced Health Directive, is the Durable Power of Attorney.

The directive may also choose an “agent”. The agent can make decisions about an individual’s health care treatments when the individual loses capacity to do so.

Power of Attorney:

There are 3 types of Power of Attorney which are listed below.

  • 1. General Power of Attorney: A legal document that gives an agent the financial rights of the person signing the document. If this document is signed when the person doesn’t have the mental capacity to do so, it is void. If they become incapacitated, it becomes void.
  • 2. Durable Power of Attorney: It works the same way as the general, but it doesn’t lose power after someone loses capacity.
  • 3. Springing Power of Attorney: This gives the recipient the rights of an individual only after he/she is incapacitated.

All types of Power of Attorney can be limited in the scope of rights.

*Credit: Elder Law and Advocacy – San Diego

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