Advance Health Care Directive

An advance health care directive is a personal statement about one’s future medical care that states our desires and wishes when we are unable to speak for ourselves. Generally speaking, family members will not have to guess or argue over our wishes because we have placed our decisions in writing and shared those decisions with those who need to know.

If we don’t have an advance health care directives on file or readily accessible, it is possible that our doctor may not honor our wishes for end-of-life care especially when there is a family dispute.

Why is an Advance Health Care Directive Needed?

Patients in a condition with no hope of recovery can be kept alive for years via respirators and feeding tubes. No matter how we feel about that possibility, it is extremely important for us to discuss what kind of care we want before a serious illness or accident occurs, while we can still make our own decisions.

What Do I Put In My Advance Health Care Directives?

If there is no hope of recovery, one needs to state whether we want to be kept alive by machines or apparatus that breathe for us or feed us. Name the person (and an alternate) we want to make decisions for us if we are not able to decide for ourselves. This surrogate decision maker does not have to be an attorney. The surrogate does have the right to accept or refuse any kind of medical care, choose doctors, and view all medical records, unless there are limitations placed upon this agent’s authority. There needs to be an indication whether pain medication should be offered and where last days are to be spent. Spiritual, ethical and religious instructions can also be specified.

How Can I Ensure That My Advance Health Care Directive Is Honored?

Copies should be shared with people who will be involved in our care and in the decision-making. Our doctors should make our advance health care directive part of our medical records.

Instructions For am Advance Health Care Directive

Download the Advance Health Care Directive Form

Complete parts 1 and 2 on the Advance Health Care Directive Form. Pages may be added and changes made. An attorney is not needed to complete this form.

Part 1 – Individual Instruction

Instructions may given to one’s doctor and others about any aspect of your healthcare. There will be choices to be made. Check only one box in each category and cross out all that do not apply.

Part 2 – Healthcare Power of Attorney

Select one or more persons to be your agent and make health care decisions if you are unable. The person appointed can be a spouse, adult child, friend or any other trusted person. Your agent cannot be an owner or employee of a healthcare facility unless they are related.

Ask two witnesses to sign and date the form. Both must be people you know. They cannot be healthcare providers (i.e. – doctor, nurse or social worker, employees of a healthcare facility, or the person chosen as an agent.) One of the two persons cannot be related to you or have inheritance rights.

If you do not have 2 witnesses, your advance health care directive must be notarized.

When You Have Completed Your Advance Health Care Directive

Be sure to have it witnessed or notarized and inform your family, friends, and doctors that you have done this. Give copies of your advance health care directive to your healthcare agent, doctors, and others who might be involved in your care. Keep a copy in an easy to find place in your home.

For more information on Advance Health Care Directives:
Hospice Hawaii
808-924-9255
info@hospicehawaii.org

UH Elder Law Program
808-956-6544
www.hawaii.edu/uhelp

Kokua Mau
808-474-2113
www.kokuamau.org