(AHCD) A nursing home cannot require a resident to have one

An Advance Health Care Directive (AHCD) is a document that allows you to name someone you trust to make medical decisions for you if you become unable to make those decisions for yourself.  A generic AHCD form is here.

The basic AHCD allows you to name a primary agent and up to two alternate agents. When the AHCD comes into play, the doctor should have ONE person to contact to make the final end of life decisions.

Picking the right agent is critical. If you feel your eldest daughter should be the agent because of her seniority, but you know that making the end of life decision might be emotionally difficult for her, perhaps you should choose another relative or friend who you know will abide by your end of life wishes.

The AHCD usually takes affect only when you are no longer able to make decisions for yourself, although  it is possible to give your agent the power to make decisions starting immediately. As elder advocates, however, we fell it is

essential that everyone have the opportunity to make their own decisions for as long as possible.

If the doctors have determined that you are in an irreversible condition and have only a short time to live, you may choose whether you want the doctor to allow to die as gently as possible, out of pain, or if you want the health care professionals to do all they can to keep you alive. You may also indicate whether you want to be an organ donor.

In the State of California it is not necessary to have an Advanced Health Care Directive notarized. Your signature needs to be witnessed by two people. In a Skilled Nursing Facility, the Ombudsman is required to sign as a witness for two reasons: to be certain that the resident has the capacity to understand what the document is about and clear about their decision; and that he/she is not being coerce.