For Patients

Advance Healthcare Directive

California and federal law give every competent adult, 18 years of age or older, the right to make their own healthcare decisions, including the right to decide what medical care or treatment to accept, reject or discontinue. If you do not want to receive certain types of treatment, or if you wish to name someone to make healthcare decisions for you, you have the right to make these desires known to your doctor, hospital or other healthcare providers, and have these rights respected. You also have the right to be told about the nature of your illness in terms that you can understand, the general nature of the proposed treatments, the risks of failing to undergo these treatments and any alternative treatments or procedures that may be available to you.

However, there may be times when you cannot make your wishes known to your doctor or other healthcare providers. For example, if you were critically injured or ill, what would be your specific wishes about the medical care you want to receive?

Advance Healthcare Directives can be used to inform your healthcare team about medical care and treatment options as well as your right to select another person to make decisions for you if you are physically or mentally unable to make them.

Your nurse will ask you if you have a completed Advance Healthcare Directive. If you have questions about completing an Advanced Healthcare Directive, or would like to complete an Interim Directive, please seek help from your nurse, case manager, social worker or spiritual care personnel.

Advance Directive Tool Kit

Learn how to make decisions about the care you would want to receive if you become unable to speak for yourself. Download a copy of Providence St. Joseph Health Advance Directive tool kit to assist you and your family in having the conversation, selecting a health care decision maker and completing an Advance Directive.

Five Wishes

Five Wishes

Five Wishes serves as an Advance Directive and is a legally-valid tool available for your use. Five Wishes helps ensure your wishes, and those of your loved ones, will be respected-even if you cannot speak for yourself. To learn more about Five Wishes, please contact Mission Hospital’s Spiritual Care department at (949) 364-1400 ext. 5399.

POLST (Physician Order for Life Sustaining Treatment)

A new law effective 1/1/16 allows Nurse Practitioners and Physician Assistants to sign the California POLST form. The form is now available in ENGLISH and will be available in other languages later in January 2016. For more information visit www.capolst.org

Click here for more information and to download a copy of the POLST in English, Spanish, Chinese, Vietnamese, Korean, Farsi, Armenian, Russian, Tagalog and Hmong.

POLST Forms

Click here to download a 2016 California POLST form in English.

How to Get Started

The Center for Advance Care Planning and Advocacy

The best time to start the conversation about the kind of care you’d want if you were in an accident or became seriously ill is now. The Center for Advance Care Planning and Advocacy is dedicated to engaging the community and health care providers in conversations about what matters and ensuring that our patient’s care preferences are honored. We can help you think about the care you’d want, talk to your loved ones about your decisions, choose your advocate andcomplete an advance directive. For additional resources, please visit our website atwww.talkaboutwhatmatters.org

Start the Conversation with these Four Steps:

  1. THINK- about your values, goals and care preferences if you were to become seriously ill
  2. TALK - to your loved ones about these care preferences
  3. CHOOSE - someone to speak for you if you can’t speak for yourself
  4. COMPLETE - an Advance Directive