A National Cancer Institute-designated Comprehensive Cancer Center

Make an appointment: 800-826-HOPE
FAQs Bookmark and Share

Advance Directive - FAQs

What are advance health care directives?

Advance health care directives are written instructions to your loved ones and medical team about the type of medical treatment and health care that you would like to receive in the event that you are unable to speak directly with your health care providers.  Because these instructions are made before the medical treatment and health care is actually needed, they are often referred to as “advance directives.”

What is a health care agent?

An agent is a relative or friend who you trust to make medical decisions for you if you cannot make them yourself.

Who should be my agent(s) for health care?

This is a very important question.  You should think very carefully about whom you want to be your agent. Whomever you decide to name as your agent under your durable power of attorney for health care, it should be someone you know very well.  It should also be someone you respect and someone whose judgment you value.  The person you name as your agent should be somewhat knowledgeable about medical issues, although it’s not necessary that this person have any medical training. 
 
This person should also have a good understanding of who you are and what your values and wishes are.  After all, this person could be stepping into your shoes to make the very difficult medical decisions that you would have to make for yourself if you were able to do so.  This individual also has to be over the age of 18.

Can I name more than one agent to act (speak on my behalf) for me?

Yes.  You can appoint as many agents as you would like; however, if you appoint more than one agent, then you should specify whether each agent can act separately or whether they all must act together. There are advantages and disadvantages to having one or two agents.  Requiring your agents to act   together can safeguard the soundness of their decisions, but it may be difficult for them to come to an agreement on all decisions. 
 
If any one of them can make decisions for you, that may be much easier to get things done, but it also may cause serious disagreements among them if they are not told in advance.  Another option is to appoint only one agent, with another named as an alternate in case the first named agent is unable to act for you.  Regardless of which option you choose, it is important to have conversations with each person before you appoint them as your agent to ensure that they are aware and in agreement with being your durable power of attorney for health care.

Where can I get the advance health care directive form at City of Hope?

You can ask your doctor, nurse or clinical social worker for the form or you can get a copy at the Sheri & Les Biller Patient and Family Resource Center at City of Hope.  You can also access and print it here .

Who can I talk to about an advance health care directive at City of Hope?

You are encouraged to discuss your advance health care needs with the doctor who is treating you and other members of your healthcare team that are involved in your care. The more medical staff you discuss this with the better informed you can be about how you want your medical care needs met. When completing the form you can ask your health care team for clarification in any area. The Department of Supportive Care Medicine has many disciplines here to discuss this important matter with you. You can also schedule an appointment with your assigned social worker and get direction and guidance.

How does the form become valid?

  • One or more of the sections is completed
  • The form is signed and dated by you, the patient. The form can be signed by another adult at the request of the patient and in the patient’s presence.
  • The form is properly witnessed
    • Your signature in Part 5 must be witnessed, by either two witnesses or notarized by a notary public. The witnesses can only include one blood relative and your power of attorney cannot serve as a witness or any City of Hope employee.
    • At City of Hope we have free notary services, you can arrange for an appointment by going to the Biller Patient and Family Resource center and request an appointment or by calling 626-218-CARE (2273). Your assigned social worker will be notified to review the document before it is notarized.

What do I do with the form when it is complete and validated?

  • Provide a copy to your agent(s) and keep one for yourself.
  • Provide a copy to Medical Records at City of Hope. It will be electronically attached to your medical record.
  • Provide a copy to all other medical facilities where you receive care.

How can I ensure that my values and goals will be honored?

California law requires that medical service providers honor your wishes regarding medical care and treatment.  However, conflicts sometimes arise when there is a lack of communication between medical service providers and family members.  This is another reason why you should communicate your wishes to your family members, your doctor and your health care team in addition to stating your wishes in the form of an advance health care directive as early as possible.

How long will my advance health care directive last?

There is no time limit for these documents.  Generally they will last until you change them or terminate them.  You may change them at any time and update the form from time to time by simply completing new documents.  It is always a good idea to destroy your old documents so that they aren’t confused with your new ones.  You may also terminate them at any time by:
  • Signing a written statement to that effect.
  • Destroying the original and all copies.
  • Telling at least two people that you are terminating them.
  • Completing a new advance health care directive.

What other kind of health care directives are there?

  • There are two other kinds of health care directives.  The first is called a “durable power of attorney for health care” or a “health care proxy.” 
  • The second is called a “living will.”

Am I required to have both a durable power of attorney and a living will?

No. You are not required to have any of these.  But, one or more of them is a good way to ensure that your wishes are known if you’re ever in a situation where you are unable to speak for yourself.  If your wishes are known, then your healthcare team will know what procedures to follow and your family and friends will be spared the agony of second-guessing what you would have wanted.

What is a durable power of attorney for health care?

A “durable power of attorney for health care” or “DPOA” is a legal document in which you name another person as your agent to make health care decisions for you in the event that you are unable to.  A durable power of attorney for health care pertains only to your health care decisions, not financial matters. 
 
You can include instructions about the types of medical treatments you want or don’t want as well as information about your personal goals, values and preferences, where you want to receive care, instructions about artificial nutrition and hydration, etc.  You can be as general or as specific as you like because it is your directive to your designated agent(s).

What is a living will?

A living will is a legal document that states your preferences for medical treatment if you are terminally ill or permanently unconscious and unable to actively take part in making decisions for your own life.  Under a living will, you can state whether you want or don’t want certain life-sustaining procedures, including artificial respiration, cardiopulmonary resuscitation, and artificial means of providing nutrition and hydration.
 
The term “terminally ill” generally means that you have an incurable or irreversible medical condition that will result in death within a relatively short amount of time.  The term “permanently unconscious” generally means that you are in a permanent coma or a persistent vegetative state, which is an irreversible condition in which you are not aware of yourself or your environment and show no response to the environment.

Can I decide what treatment I want under a living will?

Yes. That decision is entirely up to you.  But, it’s an important decision that should be discussed with your loved ones and your health care team.  Some people feel comfortable making a living will, while many others do not.  Talk with your doctor regarding your medical condition in addition to family and friends to determine what is best for you.
 
To discuss questions in regards to completing your advance health care directive, contact the Biller Patient and Family Resource Center at 626-218-CARE (2273). Your assigned social worker will then be notified to assist you.

FAQs

Advance Directive - FAQs

What are advance health care directives?

Advance health care directives are written instructions to your loved ones and medical team about the type of medical treatment and health care that you would like to receive in the event that you are unable to speak directly with your health care providers.  Because these instructions are made before the medical treatment and health care is actually needed, they are often referred to as “advance directives.”

What is a health care agent?

An agent is a relative or friend who you trust to make medical decisions for you if you cannot make them yourself.

Who should be my agent(s) for health care?

This is a very important question.  You should think very carefully about whom you want to be your agent. Whomever you decide to name as your agent under your durable power of attorney for health care, it should be someone you know very well.  It should also be someone you respect and someone whose judgment you value.  The person you name as your agent should be somewhat knowledgeable about medical issues, although it’s not necessary that this person have any medical training. 
 
This person should also have a good understanding of who you are and what your values and wishes are.  After all, this person could be stepping into your shoes to make the very difficult medical decisions that you would have to make for yourself if you were able to do so.  This individual also has to be over the age of 18.

Can I name more than one agent to act (speak on my behalf) for me?

Yes.  You can appoint as many agents as you would like; however, if you appoint more than one agent, then you should specify whether each agent can act separately or whether they all must act together. There are advantages and disadvantages to having one or two agents.  Requiring your agents to act   together can safeguard the soundness of their decisions, but it may be difficult for them to come to an agreement on all decisions. 
 
If any one of them can make decisions for you, that may be much easier to get things done, but it also may cause serious disagreements among them if they are not told in advance.  Another option is to appoint only one agent, with another named as an alternate in case the first named agent is unable to act for you.  Regardless of which option you choose, it is important to have conversations with each person before you appoint them as your agent to ensure that they are aware and in agreement with being your durable power of attorney for health care.

Where can I get the advance health care directive form at City of Hope?

You can ask your doctor, nurse or clinical social worker for the form or you can get a copy at the Sheri & Les Biller Patient and Family Resource Center at City of Hope.  You can also access and print it here .

Who can I talk to about an advance health care directive at City of Hope?

You are encouraged to discuss your advance health care needs with the doctor who is treating you and other members of your healthcare team that are involved in your care. The more medical staff you discuss this with the better informed you can be about how you want your medical care needs met. When completing the form you can ask your health care team for clarification in any area. The Department of Supportive Care Medicine has many disciplines here to discuss this important matter with you. You can also schedule an appointment with your assigned social worker and get direction and guidance.

How does the form become valid?

  • One or more of the sections is completed
  • The form is signed and dated by you, the patient. The form can be signed by another adult at the request of the patient and in the patient’s presence.
  • The form is properly witnessed
    • Your signature in Part 5 must be witnessed, by either two witnesses or notarized by a notary public. The witnesses can only include one blood relative and your power of attorney cannot serve as a witness or any City of Hope employee.
    • At City of Hope we have free notary services, you can arrange for an appointment by going to the Biller Patient and Family Resource center and request an appointment or by calling 626-218-CARE (2273). Your assigned social worker will be notified to review the document before it is notarized.

What do I do with the form when it is complete and validated?

  • Provide a copy to your agent(s) and keep one for yourself.
  • Provide a copy to Medical Records at City of Hope. It will be electronically attached to your medical record.
  • Provide a copy to all other medical facilities where you receive care.

How can I ensure that my values and goals will be honored?

California law requires that medical service providers honor your wishes regarding medical care and treatment.  However, conflicts sometimes arise when there is a lack of communication between medical service providers and family members.  This is another reason why you should communicate your wishes to your family members, your doctor and your health care team in addition to stating your wishes in the form of an advance health care directive as early as possible.

How long will my advance health care directive last?

There is no time limit for these documents.  Generally they will last until you change them or terminate them.  You may change them at any time and update the form from time to time by simply completing new documents.  It is always a good idea to destroy your old documents so that they aren’t confused with your new ones.  You may also terminate them at any time by:
  • Signing a written statement to that effect.
  • Destroying the original and all copies.
  • Telling at least two people that you are terminating them.
  • Completing a new advance health care directive.

What other kind of health care directives are there?

  • There are two other kinds of health care directives.  The first is called a “durable power of attorney for health care” or a “health care proxy.” 
  • The second is called a “living will.”

Am I required to have both a durable power of attorney and a living will?

No. You are not required to have any of these.  But, one or more of them is a good way to ensure that your wishes are known if you’re ever in a situation where you are unable to speak for yourself.  If your wishes are known, then your healthcare team will know what procedures to follow and your family and friends will be spared the agony of second-guessing what you would have wanted.

What is a durable power of attorney for health care?

A “durable power of attorney for health care” or “DPOA” is a legal document in which you name another person as your agent to make health care decisions for you in the event that you are unable to.  A durable power of attorney for health care pertains only to your health care decisions, not financial matters. 
 
You can include instructions about the types of medical treatments you want or don’t want as well as information about your personal goals, values and preferences, where you want to receive care, instructions about artificial nutrition and hydration, etc.  You can be as general or as specific as you like because it is your directive to your designated agent(s).

What is a living will?

A living will is a legal document that states your preferences for medical treatment if you are terminally ill or permanently unconscious and unable to actively take part in making decisions for your own life.  Under a living will, you can state whether you want or don’t want certain life-sustaining procedures, including artificial respiration, cardiopulmonary resuscitation, and artificial means of providing nutrition and hydration.
 
The term “terminally ill” generally means that you have an incurable or irreversible medical condition that will result in death within a relatively short amount of time.  The term “permanently unconscious” generally means that you are in a permanent coma or a persistent vegetative state, which is an irreversible condition in which you are not aware of yourself or your environment and show no response to the environment.

Can I decide what treatment I want under a living will?

Yes. That decision is entirely up to you.  But, it’s an important decision that should be discussed with your loved ones and your health care team.  Some people feel comfortable making a living will, while many others do not.  Talk with your doctor regarding your medical condition in addition to family and friends to determine what is best for you.
 
To discuss questions in regards to completing your advance health care directive, contact the Biller Patient and Family Resource Center at 626-218-CARE (2273). Your assigned social worker will then be notified to assist you.
Quick Links
Making an Advance Directive
 
Watch this video to learn more about the importance of making an advance directive.
Advance Directive Video for healthcare providers
 
Watch City of Hope care providers discuss how having an advance directive helps to ensure  that patients’ goals through their illness are honored, so that their healthcare team can most effectively serve them.
 
 
Read this guide to learn more about how to make an advance healthcare directive. 
Advance Directive Forms
Below are the Advance Healthcare Directive forms:
 
If you have additional questions about Advance Directives, please contact us.
 
Phone: 626-256-4673, ext. 32273 (3CARE)
BillerResourceCenter@coh.org
M-F, 8 a.m. to 5 p.m.
Fax:  626-256-8625
The Department of Supportive Care Medicine is committed to patient-centered care.  We treat the whole person, supporting your practical, emotional and spiritual needs throughout your medical care.
 


NEWS & UPDATES
  • Skin cancer is the most common type of cancer in the United States today, and its incidence is on the rise. Forty to 50 percent of light-skinned Americans who live to age 65 will have skin cancer at least once in their lives. Most of these skin cancers – about 3.5 million cases – are the […]
  • The connection between lifestyle and cancer is real. Knowing that, what can individuals do to lower their risk? City of Hope physicians recently came together to answer that precise question, explaining the links between cancer and the choices we make that affect our health. Moderator Vijay Trisal M.D., medical...
  • White button mushrooms seem fairly innocuous as fungi go. Unlike portabellas, they don’t center stage at the dinner table, and unlike truffles, they’re not the subject of gourmand fervor. But appearances can be deceiving when it comes to these mild-mannered Clark Kents of the food world. In a study ...
  • Doctors often recommend preventive screenings for several cancers, based on hereditary or genetic factors, but brain tumors aren’t one of them. Primary brain tumors, which originate in the brain rather than spreading from another location, seem to develop at random, and doctors have little insight into wh...
  • Stopping cancer starts with research. To that end, STOP CANCER has awarded $525,000 in grants to City of Hope for 2015, supporting innovative research projects and recognizing the institution’s leadership in advancing cancer treatment and prevention. Founded in 1988, STOP CANCER underwrites the work of le...
  • Cancer may not be the disease many people think it is. Normally, cancer is considered to be a disease in which cells multiply at an extremely high, and unusual, rate – increasing the likelihood of genetic mutations. But increasingly, leading researchers at City of Hope and elsewhere are contending that cancer i...
  • “Of all forms of inequality, injustice in the health care system is the most shocking and inhumane.” By the time the Rev. Martin Luther King Jr. spoke those words in Chicago in 1966, the Civil Rights Act had been passed, the Voting Rights Act was the law of the land and the March on Washington was […]
  • Eight years ago, Matthew Loscalzo surprised himself by accepting the offer to become City of Hope’s administrative director of the Sheri & Les Biller Patient and Family Resource Center and executive director of the Department of Supportive Care Medicine. At the time, he was administrative director of the Sc...
  • The mental fog that patients can experience after undergoing chemotherapy treatment for cancer has a name: “chemo brain.” “Many patients report hearing or reading about chemotherapy-related cognitive deficits, but few are actually prepared to deal with these changes,” said Celina Lemon, M.A., an occupational th...
  • Cancer treatments have improved over the years, but one potential source of treatments and cures remains largely untapped: nature. Blueberries, cinnamon, xinfeng, grape seed (and skin) extract, mushrooms, barberry and pomegranates all contain compounds with the potential to treat or prevent cancer. Scientists a...
  • In the U.S., there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate and lung, according to the American Cancer Society. Each year, 5 million people are treated for skin cancer. Here, Hans Schoellhammer, M.D., assistant clinical professor at City of Hope | Ant...
  • As public health experts know, health improvement starts in the community. Now, City of Hope  has been recognized for its efforts to improve the lives of residents of its own community. The institution will receive funding from the Institute for Healthcare Improvement  to support promising community-based work ...
  • For almost four decades, blood cancer survivors who received bone marrow, or stem cell, transplants have returned to City of Hope to celebrate life, second chances and science. The first reunion, in 1976, was a small affair: spaghetti for a single patient, his brother who served as his donor and those who took ...
  • Chemotherapy is an often-essential component of cancer treatment, attacking cells that divide quickly and helping stop cancer’s advance. But the very characteristics that make chemotherapy effective against cancer also can make it toxic to healthy cells, leading to side effects such as hair loss, nausea, ...
  • When you want to understand how to enhance the patient experience, go straight to the source: The patients. Patients and their families offer unique perspectives on care and services and can provide valuable insights about what is working well and what is not. That’s why City of Hope turns to them for advice. S...