Mills-Peninsula Health Blog

Be Well, Be Well Informed

Advance Health Care Directives Help Make Your Wishes Known  

Posted on Jan 5, 2016 in Uncategorized


Too often, doctors and families are unable to honor patients’ or loved ones’ wishes for care during a serious illness because the patient has not made his or her health care wishes known in advance. Within Mills-Peninsula’s support and coaching program for older adults leaving the hospital, called Peninsula Circle of Care, nurses see this situation frequently.

“Many people that we work with have thought about their wishes,” Yvonne Chan, R.N., MSN, GCNS-BC, program manager for the Peninsula Circle of Care, says. “But few of them put that information into an advance health care directive document that can be referenced in case a medical situation arises if they are unable to speak for themselves.”

Waiting until a serious illness or accident occurs to do this type of planning is problematic, Chan says. Sometimes when people are hospitalized for serious illness, they are unable to communicate their wishes or are overwhelmed with the anxiety that comes with a serious diagnosis. “At that time, a person is not always able to make clear decisions about their personal health care wishes,” she says.

“Changes can happen in your life very suddenly,” Patricia Firenze, R.N., M.A., says. Firenze is a nurse care manager with the Peninsula Circle of Care who helps seniors fill out advance care directives. “You don’t want to put your family in the position of having to guess at your wishes for your medical care. And although documenting your wishes can feel overwhelming, remember that it doesn’t need to be done all at once and you can always make changes to the document later on if needed.”

Partnering With Community

To help educate people about the importance of advance care planning, Mills-Peninsula and the Peninsula Circle of Care are offering free workshops at Mills-Peninsula Medical Center in Burlingame:

Jan. 12, 2016, 11 a.m. to 1 p.m.

Jan. 19, 2016, 2 to 4 p.m.

Jan. 21, 2016, 10 a.m. to noon

Jan. 29, 2016, 4 to 6 p.m.

Register for any one of these sessions by calling 650-696-3660. Refreshments will be provided.

Starting the Conversation

Since families often gather over holidays, this can sometimes be a good time to discuss your wishes for medical care with loved ones face-to-face. The Coalition for Compassionate Care website offers a useful guide with tips to help you think about ways to start talking with your loved ones about what care you want during serious illness or for end-of-life care.

You can learn more about advance care planning and download a free advance care planning form on the Mills-Peninsula website. Useful checklists and a video about advance care planning are also available at

Terms to Know When Documenting Your Wishes

Advance Health Care Directive (AHCD)

This is an official form recognized as a legal document in the United States when signed in the presence of witnesses or a notary. The form allows you to name a person that will make health care decisions for you in the event you cannot make or express your decisions for yourself and allows you to describe specifically what actions should or should not be taken at that time. Make sure you give a copy of your AHCD to your doctor, keep a copy at home and provide copies to family members. You can download the form in English and Spanish from the California Hospital Association website.

Do Not Resuscitate (DNR) Order

This is an official California state document developed by the California Emergency Medical Services Authority and the California Medical Association that allows you to refuse certain resuscitative measures that may keep you alive if your heart or breathing stops. A person with a completed DNR may choose to wear a DNR medallion that medical personnel can easily see in an emergency situation. Unlike the AHCD, this form needs your physician’s signature to become valid.

Physician Orders for Life-Sustaining Treatment (POLST)

This is similar to a DNR form but contains additional information that covers situations that may arise if Emergency Medical Services come to your home to assist you or if you are in a hospital. Like the DNR form, your physician needs to sign it to make it valid. After January 1, 2016, a change in California law will allow nurse practitioners and physician assistants to also sign a POLST form for you.