Advance Health Care Directives

An advance health care directive is a personal statement about your future medical care that states your desires and wishes when you’re unable to speak for yourself. Generally speaking, family members will not have to guess or argue over your wishes because you have outlined your decisions in writing and shared those decisions with those who need to know.

If you don’t have an advance health care directive on file or readily accessible, it’s possible that your doctor may not honor your 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 Directive?

If there is no hope of recovery, you would need to state whether you want to be kept alive by machines or equipment that breathe for us or feed us. Name the person (and an alternate) who you want to make decisions for you if you are not able to decide for yourself. This surrogate decision maker doesn’t 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 your care and in the decision-making. Your doctors should make your advance health care directive part of your medical records.

Instructions for an 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 – Health Care 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 health care facility, unless they are related to you.

Ask two witnesses to sign and date the form. Both must be people you know. They cannot be health care providers (i.e. – doctor, nurse or social worker, employees of a health care 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 two witnesses, your advance health care directive must be notarized.

Part 2 – Individual Instructions

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

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 health care agent, doctors and others who might be involved in your care. Keep a copy in a safe, easy-to-find place in your home.

For more information on Advance Health Care Directives:

Hospice Hawaii
808-924-9255
info@hospicehawaii.org

University of Hawaii Elder Law Program
808-956-6544
www.hawaii.edu/uhelp

Kokua Mau – Hawaii Hospice and Palliative Care Organization
808-585-9977
www.kokuamau.org