HEALTHCARE DIRECTIVES

Advance Healthcare Directive

Put your medical wishes in writing and choose who speaks for you.

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Prepared by Jay S. Yu, Esq., California Licensed Attorney · Yu & Yu Law, Fullerton · Last reviewed October 2026

WHAT IT IS

A roadmap for your medical care

An advance healthcare directive guides your medical care if you cannot speak for yourself. In California, a complete directive usually combines health care instructions, once called a living will, with a power of attorney for health care.

WHY IT MATTERS

Why you need one

01

Avoid court involvement

Without clear instructions, your family may have to ask a court for a conservatorship, which is slow, costly, and invasive.

02

Your choices, in writing

State what you want about life-sustaining treatment, organ donation, and even spiritual or burial preferences.

03

Clarity for doctors

Your physicians can follow your values instead of defaulting to measures you may not want.

CHOOSING YOUR AGENT

Who should speak for you

Your health care agent should know your values well and stay calm under pressure.

01

A strong advocate

Your agent may need to stand up for your wishes with medical staff or with family members who disagree.

02

Nearby if possible

It is not required, but an agent who lives close by can matter during a long illness.

03

No conflicts

Your agent generally should not be your treating provider or work at a care facility where you receive care.

WHEN TO UPDATE

The five D’s

The American Bar Association suggests reviewing your directive at these milestones:

Decade: every 10 years, to confirm your values have not shifted
Death: after the loss of a family member or close friend
Divorce: after a divorce or other major family change
Diagnosis: when you receive a serious medical diagnosis
Decline: if your general health declines significantly

MAKING IT BINDING

California signing requirements

01

Competency

You must be a competent adult when you sign.

02

Witnesses or notary

You sign before two qualified witnesses, or the directive is acknowledged before a notary public.

03

Skilled nursing facilities

If you are a patient in a skilled nursing facility, a patient advocate or ombudsman must also sign as a witness.

QUESTIONS CLIENTS ASK

How healthcare directives work in California

Does an advance directive need to be notarized in California?

No. It must be dated and signed, then either acknowledged before a notary or signed by two qualified adult witnesses (Prob. Code § 4673). Your witnesses cannot include your agent or your health care provider, and in a skilled nursing facility, a patient advocate or ombudsman must also sign.

Is a living will the same as an advance directive?

In California, the living will is part of the advance health care directive. One document names your health care agent and records your instructions about treatment, life support, pain relief, and organ donation, so you do not need a separate living will. Read What Is an Advance Healthcare Directive?

When does my health care agent's authority start?

Unless your directive says otherwise, your agent's authority starts only when it is determined that you lack capacity to make your own decisions, and it ends if you recover (Prob. Code § 4682). In California, your primary physician makes that determination. You can choose instead to make your agent's authority effective right away.

Can my agent see my medical records?

Yes, unless you limit it. California gives your agent the same right you have to request, receive, and review your medical information and to consent to its disclosure (Prob. Code § 4678). That matters when your agent is talking with doctors at more than one hospital or reviewing test results before a decision.

How is a directive different from a POLST or DNR?

Your directive is a legal document you sign in advance, at any age. A POLST or a do-not-resuscitate order is a medical order signed by a clinician for someone who is seriously ill, telling emergency staff what to do now. Many people have both. Read What Is a DNR Order?

Can I register my directive with the state?

Yes. The California Secretary of State keeps an Advance Health Care Directive Registry, where you can register your directive or where it is kept so a health care provider can request it (Prob. Code § 4800). Registering is optional, and an unregistered directive is fully valid. Giving copies to your agent and your doctor matters more.

Can I change or revoke my directive?

Yes, while you have capacity. You can revoke your choice of agent only by a signed writing or by personally telling your supervising health care provider; the rest of the directive can be revoked in any way that shows your intent (Prob. Code § 4695). The cleanest way to make a change is to sign a new directive.

How much does a healthcare directive cost?

An advance healthcare directive for each person is included in my Complete Estate Plan, a flat fee quoted in writing before any work begins. The plan also includes your living trust, pour-over will, powers of attorney, and the trust deed for your home. See what is included.