--- title: "Advance Health Care Directive at Sutter Health" description: "Information you need to make the right decisions for you. Learn about completing an Advance Health Care Directive to help guide decisions about your medical care if you are unable to communicate." url: "https://www.sutterhealth.org/patient-resources/records-planning/advance-directive" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Patient resources](https://www.sutterhealth.org/patient-resources) / 3. [Records planning](https://www.sutterhealth.org/patient-resources/records-planning) / 4. Advance Health Care Directive # Advance Health Care Directive  **Section menu** - [Patient resources](https://www.sutterhealth.org/patient-resources "Patient resources") - [Billing and Insurance](https://www.sutterhealth.org/patient-resources/billing-and-insurance "Billing and Insurance") - [Bioethics services](https://www.sutterhealth.org/patient-resources/bioethics-services "Bioethics services") - [Bioethics team](https://www.sutterhealth.org/patient-resources/bioethics-services/team "Bioethics team") - [Pacific Employment Program](https://www.sutterhealth.org/patient-resources/pacific-employment-program "Pacific Employment Program") - [Sutter Care Management](https://www.sutterhealth.org/patient-resources/sutter-care-management "Sutter Care Management") - [Classes and events](https://www.sutterhealth.org/patient-resources/classes-events "Classes and events") - [Flu and COVID-19 resources](https://www.sutterhealth.org/patient-resources/flu-and-covid-19-resources "Flu and COVID-19 resources") - 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[End of Life Option](https://www.sutterhealth.org/patient-resources/records-planning/end-of-life-option "End of Life Option") - [Request Medical Records](https://www.sutterhealth.org/patient-resources/records-planning/request-medical-records "Request Medical Records") - [Remington Lab](https://www.sutterhealth.org/patient-resources/remington-laboratory "Remington Lab") - [Clinician information](https://www.sutterhealth.org/patient-resources/remington-laboratory/clinician-information "Clinician information") - [FAQs](https://www.sutterhealth.org/patient-resources/remington-laboratory/frequently-asked-questions "FAQs") - [Patient information](https://www.sutterhealth.org/patient-resources/remington-laboratory/patient-information "Patient information") - [Remington Lab tests menu and information](https://www.sutterhealth.org/patient-resources/remington-laboratory/serology-tests "Remington Lab tests menu and information") - [Spiritual care and chaplaincy services](https://www.sutterhealth.org/patient-resources/spiritual-care-and-chaplaincy-services "Spiritual care and chaplaincy services") - [Patient resources](https://www.sutterhealth.org/patient-resources "Patient resources") - [Billing and Insurance](https://www.sutterhealth.org/patient-resources/billing-and-insurance "Billing and Insurance") - [Bioethics services](https://www.sutterhealth.org/patient-resources/bioethics-services "Bioethics services") - [Bioethics team](https://www.sutterhealth.org/patient-resources/bioethics-services/team "Bioethics team") - [Pacific Employment Program](https://www.sutterhealth.org/patient-resources/pacific-employment-program "Pacific Employment Program") - [Sutter Care Management](https://www.sutterhealth.org/patient-resources/sutter-care-management "Sutter Care Management") - [Classes and events](https://www.sutterhealth.org/patient-resources/classes-events "Classes and events") - [Flu and COVID-19 resources](https://www.sutterhealth.org/patient-resources/flu-and-covid-19-resources "Flu and COVID-19 resources") - [Health Education Resource Centers](https://www.sutterhealth.org/patient-resources/health-education-resource-centers "Health Education Resource Centers") - [Language assistance](https://www.sutterhealth.org/patient-resources/language-assistance "Language assistance") - [My Health Online](https://www.sutterhealth.org/patient-resources/my-health-online "My Health Online") - [Help center](https://www.sutterhealth.org/patient-resources/my-health-online/help-center "Help center") - [Account and technical FAQs](https://www.sutterhealth.org/patient-resources/my-health-online/help-center/account-technical-questions "Account and technical FAQs") - [Billing and insurance FAQs](https://www.sutterhealth.org/patient-resources/my-health-online/help-center/billing-and-insurance-questions "Billing and insurance FAQs") - [Care and clinical FAQs](https://www.sutterhealth.org/patient-resources/my-health-online/help-center/care-and-clinical-questions "Care and clinical FAQs") - [Emmie - AI assistant FAQs](https://www.sutterhealth.org/patient-resources/my-health-online/help-center/emmie-ai-assistant-questions "Emmie - AI assistant FAQs") - [Sansum patients FAQs](https://www.sutterhealth.org/patient-resources/my-health-online/help-center/sansum-patients "Sansum patients FAQs") - [Video Visit FAQs](https://www.sutterhealth.org/patient-resources/my-health-online/help-center/video-visit-questions "Video Visit FAQs") - [Register for delivery](https://www.sutterhealth.org/patient-resources/my-health-online/delivery-pre-register "Register for delivery") - [How to enroll](https://www.sutterhealth.org/patient-resources/my-health-online/enroll "How to enroll") - [Proxy access](https://www.sutterhealth.org/patient-resources/my-health-online/proxy-access "Proxy access") - [My Health Online teen enrollment](https://www.sutterhealth.org/patient-resources/my-health-online/teen-enrollment "My Health Online teen enrollment") - [On-demand video visit waiting room](https://www.sutterhealth.org/patient-resources/my-health-online/odvv-waiting-room "On-demand video visit waiting room") - [Patient and Family Advisory Councils](https://www.sutterhealth.org/patient-resources/patient-advisory-council "Patient and Family Advisory Councils") - [Privacy](https://www.sutterhealth.org/patient-resources/privacy "Privacy") - [Notice of privacy practices](https://www.sutterhealth.org/patient-resources/privacy/hipaa-privacy "Notice of privacy practices") - [Patient rights and responsibilities](https://www.sutterhealth.org/patient-resources/privacy/patient-rights-and-responsibilities "Patient rights and responsibilities") - [Privacy policy](https://www.sutterhealth.org/patient-resources/privacy/privacy-policy "Privacy policy") - [Secure Health Information Exchange FAQs](https://www.sutterhealth.org/patient-resources/privacy/health-information-exchange "Secure Health Information Exchange FAQs") - [Terms of Use](https://www.sutterhealth.org/patient-resources/privacy/terms-of-use "Terms of Use") - [Records planning](https://www.sutterhealth.org/patient-resources/records-planning "Records planning") - [Advance Health Care Directive](https://www.sutterhealth.org/patient-resources/records-planning/advance-directive "Advance Health Care Directive") - [End of Life Option](https://www.sutterhealth.org/patient-resources/records-planning/end-of-life-option "End of Life Option") - [Request Medical Records](https://www.sutterhealth.org/patient-resources/records-planning/request-medical-records "Request Medical Records") - [Remington Lab](https://www.sutterhealth.org/patient-resources/remington-laboratory "Remington Lab") - [Clinician information](https://www.sutterhealth.org/patient-resources/remington-laboratory/clinician-information "Clinician information") - [FAQs](https://www.sutterhealth.org/patient-resources/remington-laboratory/frequently-asked-questions "FAQs") - [Patient information](https://www.sutterhealth.org/patient-resources/remington-laboratory/patient-information "Patient information") - [Remington Lab tests menu and information](https://www.sutterhealth.org/patient-resources/remington-laboratory/serology-tests "Remington Lab tests menu and information") - [Spiritual care and chaplaincy services](https://www.sutterhealth.org/patient-resources/spiritual-care-and-chaplaincy-services "Spiritual care and chaplaincy services") Sutter tips: Advance Care Planning and Advance Directives  It's often difficult to think about the care and treatment you may want in the event you are incapable of making your own healthcare decisions. You may unexpectedly be in a position where you cannot speak for yourself — such as an accident or severe illness — and be unable to make or communicate your treatment decisions. If this happens, you want to be assured that the decisions made match your values and wishes. You can define in advance what medical treatment you prefer. [An Advance Health Care Directive (AHCD)](https://www.sutterhealth.org/health/advanced-healthcare-directives) form lets you say what you want and who you want to speak for you. An AHCD allows you to appoint an agent who has power of attorney for healthcare to make care and treatment decisions on your behalf, and give instructions about your healthcare wishes. As you prepare your advance directive, you'll need to follow these four important steps: 1. Get the Advanced Health Care Directive and/or Power of Attorney for Healthcare forms for your state. In general, doctors will respect your wishes even if you have a form from a different state. The California form can be downloaded, below. 2. Choose your healthcare agent(s). This should be a person or persons you trust to make decisions for you. 3. Fill out the forms and have your signature witnessed, as your state requires. 4. Give copies to your family, your doctor and your healthcare agent. Keep an extra copy for yourself in case you need to go to a healthcare facility for a procedure or illness. Helpful resources [Bioethics consultation](https://www.sutterhealth.org/patient-resources/bioethics-services) [Planning my way](http://www.planninghealthcaremyway.org/ "Please note you are now leaving the Sutter Health website") ## California Advance Health Care Directive form Provided by PREPARE for YOUR care. [Access form](https://prepareforyourcare.org/en/prepare-for-your-care/welcome) Disclaimer _The Advance Care Planning information contained on this website is for general information purposes only. While we at Sutter endeavor to keep the information up to date and non-bias, we make no representations or warranties of any kind, express or implied, about the quality, accuracy, or ongoing availability of the information, products, services, or related graphics they contain. Any reliance you place on such information must be done using your own judgment. Also, through this website you are able to link to other websites which are not under the control of Sutter Health, therefore we do not necessarily imply a recommendation or endorse the views expressed within them._ ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"WebPage","name":"Advance Health Care Directive at Sutter Health","description":"Information you need to make the right decisions for you. Learn about completing an Advance Health Care Directive to help guide decisions about your medical care if you are unable to communicate.","url":"https://www.sutterhealth.org/patient-resources/records-planning/advance-directive","breadcrumb":{"@id":"https://www.sutterhealth.org/patient-resources/records-planning/advance-directive#breadcrumblist"}} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/patient-resources/records-planning/advance-directive#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Patient resources","item":"https://www.sutterhealth.org/patient-resources"},{"@type":"ListItem","position":3,"name":"Records planning","item":"https://www.sutterhealth.org/patient-resources/records-planning"},{"@type":"ListItem","position":4,"name":"Advance Health Care Directive"}]} ``` ```json {"@context":"https://schema.org","@type":"VideoObject","name":"Sutter Tips: Advance Care Planning and Advance Directives","thumbnailUrl":"https://cf-images.us-east-1.prod.boltdns.net/v1/static/817826402001/746d716b-1b87-4ffc-a60b-7fa6da75eea5/24e8f6cd-37b5-4055-8063-8c485b4586d0/1280x720/match/image.jpg","uploadDate":"2020-08-06T00:57:32.197Z","embedUrl":"https://players.brightcove.net/817826402001/79bcaa57-54d7-453c-9f1f-8ab3ef7b15de/index.html?videoId=6178599379001","description":"Advance Directives help ensure that you get the treatment you want – and avoid the treatments you don’t want – if you get seriously sick and are in the hospital.","duration":"PT11M10S","transcript":"LIZZIE MOORE: Hi, my name is Lizzie Moore\nand I'm a clinical coordinator for Sutter Health,\nand I am here with doctor Frank Mueller,\nto talk about the basics of advanced care planning.\nBut before we do, I would like to say that the content is not\nintended to be a substitute for professional medical advice,\ndiagnosis, or treatment.\nYou should always seek the advice\nof your physician or other qualified provider\nwith any questions you may have regarding a medical condition.\nThe information provided in this presentation does not,\nand is not intended to, constitute legal advice;\ninstead all information, content and materials presented here\nare for general informational purposes only.\nInformation in this presentation may not\nconstitute the most up-to-date legal or other information.\nSo with that being said, I do want\nto introduce doctor Mueller.\nThere's a picture of him here.\nHe is a fellow of the American Academy of Hospice\nand Palliative Medicine.\nHe's also the medical director of palliative medicine Sutter\nSanta Rosa Regional Hospital.\nFRANK MUELLER, M.D.: Thank you, Lizzie.\nSo the purpose of an advance directive\nis to pick someone, your agent, to speak for you if you're\ntoo sick to speak for yourself.\nAnd then to record on that form what is important to you\nso your agent knows how to represent you.\nAdvance care planning is the term\nwe use when we encourage you to write down\nwhat really matters to you.\nWe want you to tell your loved ones and us,\nyour health care team, what choices\nyou want us to make to keep you alive\nif you lose the ability to decide or to speak\nfor yourself.\nIt tells others what trade offs you\nare willing to make to your quality of life\nin order to stay alive.\nSo for example, if you have that next round of cancer treatment\nand that leaves you exhausted and bed-bound,\nis that just what you wanted?\nIs that the trade-off you would choose so you have\nmore time with your family?\nA document called an advance directive\nhas been recommended for everyone over the age of 18\nfor a long time.\nIt appoints someone to speak for you\nand make medical decisions if you can't make them yourself.\nWith the COVID-19 pandemic, many patients and families\nare facing difficult treatment decisions\nin our hospitals every day.\nAn advance directive helps to ensure\nthat if you get sick from COVID or really any other cause, then\nyou get just the care you want and avoid\ntreatments you don't want.\nSome people are afraid to fill out the form.\nWe encourage you to do it, even if it feels scary.\nI often give up the advanced health care form\nand so often I see that they aren't completed.\nPeople tell me, oh, I fill out this form,\nlike it's going to cause me to die\nor I'll be acknowledging that I'm going to die.\nWe're all going to die at some point.\nSometimes we like to pretend that death is optional.\nWhen couples are expecting, we recommend careful planning\nand education for the birth and care of the baby.\nWhy shouldn't we educate ourselves and have\na plan for our own death?\nThat kind of a plan makes sense.\nWhen you're in the final stage of your life,\nhaving an advance directive in place\nwill help to ensure that your wishes are followed,\nand it will make it easier for your loved ones\nas they try to follow those wishes.\nFilling out the form doesn't mean you're going to die soon.\nHere are the steps you can take to complete an advance\ndirective.\nTalk with your family, your loved ones, and your agent,\nthat person is going to speak for you,\nand tell them about your wishes.\nSometimes I hear, gee, I didn't know\nthat Uncle Joe wanted me to be his medical decision maker.\nI don't know what he would want.\nDon't let that happen.\nMake sure somebody knows what you want.\nPeople sometimes have a way of thinking\nabout what happened to other family members\nas a way of directing the kind of care they would want.\nRemember when Mary was in the hospital\nfor so long at the end?\nI don't want that to happen to me.\nI'd rather be at home.\nOr, I thought that the many weeks of care\nthat Mary got the intensive care unit was great\nand really helped her.\nI would want that too, even though it was hard.\nSo the second part is just to complete that form.\nYou need to have your signature witnessed or notarized.\nIf you have two people sign it, they can't be related to you.\nThey can't be one of the people you\nneed to be a decision maker for you.\nThere usually is a notary service\nat mailing stores like UPS or FedEx,\nor a mom and pop store, maybe even at your bank.\nThere are a lot of traveling notaries.\nPeople who come to your home to notarize something.\nStep three is providing that copy\nto your doctor's office and or hospital,\nso the document is available to your medical team when needed.\nIt will be a part of your medical record.\nGive a copy to the person you have named as the decision\nmaker if you can't speak for yourself, known as your agent.\nYou can also give a copy to other important loved ones.\nKeep a copy for yourself.\nMany people like to keep a copy in a safe deposit box,\nbut that's the one place you can't get to when you need it.\nIt's important that you give a copy\nto your doctor or other provider to put in your medical record.\nWhy?\nIf your a medical team and loved ones\ncan't find the document when they need it,\nit's not going to help.\nBe sure members of your family have copies, too.\nYou can change an advance directive form at any time.\nAs your life changes, so can your advance directive plan.\nYour age, your health, your life situation\nmay have changed since you filled out the last one.\nReview your advance directive periodically\nor after a major life change, like a change\nin your health or a divorce.\nChange it as needed.\nBe sure to provide a copy of the new one to your loved ones\nand to your doctor to replace the old one.\nGiving an advance directive that will help your doctor the most.\nYou know, your attorney may have included an advance directive\nat the end of your will or trust.\nSometimes the language in an advance directive like that\ncan be pretty stiff and doesn't really\ntell us what is really important to you.\nIf you have an advance directive prepared by an attorney,\nyou may want to consider completing a new one that\nincludes more detail and uses words that\nare better at telling your medical team what\nis important to you.\nIf you fill out a new form, the new form\nwill take precedence over the old one just based on that date\nalone.\nHere are a couple of options for where you\ncan find an advanced directive.\nI really likes these two.\nPrepare For Your Care, and My Directives.\nSutter patients can use My Health Online\nto access a new form that we're using called Wiser Care.\nThis is a step by step in-depth electronic advance directive.\nIt walks you through those important choices.\nThis Wiser Care module results in a legal advance\ndirective which you can then have witnessed or notarized.\nYou can go back to My Health Online and change it any time,\nand each time you make a change, your doctor\nwill be notified of those changes.\nSo this slide tells you exactly how\nto access Wiser Care advance directive online\nthrough My Health Online.\nSo we're not really focusing on a POLST\nduring this presentation.\nBut I did want to give you a brief, overview\nof what POLST is and how it's different from an advance\ndirective.\nSometimes people confuse the two,\nbut they do work very well together.\nPOLST stands for physician's orders for life\nsustaining treatment.\nUnlike an advance directive, which sort of gives us\na general outline of your wishes,\na POLST is actually a physician's orders.\nThis usual bright pink form you place\non the front of your refrigerator,\ntells first responders what type of level of care\nyou would want in a 911 emergency.\nPOLST is best used in people who are sick enough\nthat we would not be surprised if they\ndied within the next year.\nPOLST first asks whether you would\nwant pressing on your chest and broken ribs and a tube\ndown your mouth and into your windpipe connected\nto a breathing machine if you are found with no pulse,\nand not breathing.\nMost people who are found with no pulse and are not breathing\nwould be said to be dead.\nThe second part of the POLST form asks what level of care\nyou would want if you were alive but seriously ill.\nFull treatment would say, pull out all the stops.\nI want to be kept alive no matter how burdensome it\nis for me or for my family.\nThe comfort care choice would say, just keep me comfortable.\nWhether I live longer is not important to me now.\nAnd then there is middle choice which says,\nselective treatment.\nWell, if I have something that's easy to treat,\nand treating it won't make me feel too bad,\nand have a good chance of getting better,\nI want to be treated.\nThe third part of the form asks whether he\nwould want artificial feeding if you lost your ability\nor desire to eat.\nIf you and your doctor determine that this form is needed,\nit should be completed, given to your doctor\nso it can be placed in your medical record,\nand then it should appear on the front of your refrigerator\nso first responders can find it.\nThat's where they are taught to go to look for it.\nYour doctor can give you a copy of a POLST form.\nIt can also sometimes be filled out online with your doctor\nat the office or at the hospital.\nLet's review the main points of this presentation.\nEveryone 18 or older should have an advance directive.\nIt helps you appoint someone to speak for you if you can't\nspeak for yourself, and helps to tell\nyour agent what is important to you they know what to say.\nYou can get an advance directive form\nat the resources I just listed.\nFill it out, have your signature witnessed or have it notarized,\nand be sure to have a copy given to your doctor,\nthe person who you name as your decision maker,\nand any other loved ones you feel should have one.\nA lot of times once people come to this forum\nthey feel a sense of relief.\nThey don't have to worry about it until it's time\nto review it again.\nThanks for your attention."} ```