Advance Health Care Planning

Everything you need to know about the advance care planning process, which involves thinking through the kind of care you would want to receive if you were unable to make healthcare decisions for yourself. 


We are happy to provide free virtual webinars, workshops, etc. about advance care planning.  We design these offerings with your input to meet your group's specific needs.  We provide interpreters and translated materials as well.  Click on the button above to request a session with us! 

What is advance health care planning?

Advance health care planning helps you plan the health care you would want to receive if you became too ill to make decisions for yourself. 

In advance care planning, you start by thinking about: 

  • What matters most to you in life
  • What gives you meaning    
  • Who you would like to make decisions for you
  • Health care you would or wouldn't want

 

Some people want to receive all possible medical treatments, no matter what.  Others want to receive medical treatments only if there is a chance they will get better with them.  These are your decisions to make. They are based on your values, preferences, and discussions with your loved ones.

A big piece of advance care planning is completing an Advance Health Care Directive. This is a legal form that contains all the information about what kind of care you would want, if you were to become very ill.  It can be completed by anyone 18 years of age or older.  

An advance health care directive is something that you can change over time, as your health and life changes.  You can make these changes at any time.

Why think about this kind of health care planning now?

"It's always too early, until it's too late."  People often think it's too early to start advance care planning, and that they don't need it "just yet."  However, no one plans to get seriously sick, or to get into an accident.  But, if these things happen and you do not have an advance care plan in place, it may be too late for you to let people know the kind of care you want.  That's why it's important to be ready now for whatever may come.  Health care teams see how hard it can be for your loved ones to make decisions for you, when they aren't really sure what you would want.

In the video below, palliative care doctor Joshua Fronk, DO,  talks more about why advance care planning is important. 

Advance care planning is not just for serious illness.  Everyone should have advance care planning done.

-Josh Fronk, DO

Although 90% of people say that talking to their loved ones about their future health care wishes is important, less than one third of people have actually done so. And 82% of people say its important to put those wishes in writing, but less than a quarter of people have actually done so.

How do I get started?

It’s normal to feel nervous about starting this process.  The good news is there are some clear steps you can take to get started.  Keep in mind, advance care planning is something you do over time.  You can always come back to your advance health care directive and change it.

1.  Talk with your doctor about your current health

It is important to know what all your health conditions are now, and how these conditions could change over time.  You will need to talk with your doctor to understand these things.  Once you know where you are now, it will help you think more clearly about the future.

2.  Think about what matters most to you

Think about your hopes and goals in life.  Think about the things you like to do or experience that give you joy and meaning in your life.  You may want to think about what fears or worries you have about the future.  It's okay to not know exactly what matters most to you, and it could change over time. 

3.  Choose a surrogate decision maker (A surrogate is someone who could make decisions for you if you were unable to do so)

Think about the person you would like to be your decision maker.  While your loved ones can make decisions together for you if they're all in agreement, one person will still need to be selected to make the final decision if there are differences in opinion. 

A good decision maker is someone who: 

  • You can trust to make the decisions you ask them to make.  Sometimes it can be hard for our loved ones to make the decisions we want. Finding someone who can follow your wishes is important. 
  • You can explain your values to, and what matters most to you, and they will listen and understand them.  You can talk to this person over time, and let them know if your decisions have changed.
  • Will be able and willing to speak up and voice your thoughts and feelings to the healthcare team
  • Is willing to play this role.  A decision maker does not need to live in your same city or state, but does need to be able to communicate with your healthcare team when they are needed

4.  Complete an Advance Health Care Directive

There are a number of Advance Health Care Directive forms that are valid in California, and here are a couple of our favorites:

  • Stanford Letter Project - provides steps to go through to think about what matters most.  It uses letter writing to think through these things.  After going through these steps, you will have a completed advance health care directive.
  • PREPARE For Your Care -an online step-by-step program to complete an advance health care directive, that is easy to understand.  It providesvideos of people thinking through their decisions at each step of the process.  This website allows you to choose the advance health care directive that is required in your state, and it provides them in multiple languages.  Click to download these PREPARE advance health care directives on the right side of this page.

Download California advance health care directives (AHCDs)


If you are a patient at Stanford


Frequently Asked Questions


The Coalition of Compassionate Care of California has a useful "FAQ" page about advance care planning here. This coalition provides information and resources for anyone who is seriously ill or near the end of life. 

How can palliative care help with advance care planning?

Palliative care teams are very skilled at helping people advance care plan.  They can take time to talk to you about this process and:

  • Help you identify what matters most to you and what having a quality of life looks like for you
  • Help you discuss your care wishes with your loved ones in a meeting, called "family meetings."  Palliative care teams have a lot of skill in working through the emotions and questions that can come up when you talk with your loved ones.
  • Communicate with your other doctors and health care teams about your advance care plan and your wishes
  • Help you to put your wishes in writing in the advance health care directive

 

Guides for talking to your loved ones

 
  • American Bar Association -- offers a toolkit for health care advance planning
  • Caring Info --provides multiple resources about advance care planning, palliative care, and hospice. This site provides resources in English, Spanish, and Mandarin
  • Defining Hope --a documentary feature about people weighing what matters most at a critical time
  • Go Wish --a card game available to order that is an easy, entertaining way to talk about what matters most.  Developed in San Jose, CA.
  • Prepare for Your Care- Offers advance health care planning resources and downloadable advance directives from multiple states
  • The American Cancer Society website includes information about advance directives
  • The Conversation Project--provides guidance about advance care planning, and how to talk to your doctors and loved ones about the care you would want if you were to become seriously ill 

 

Above resources taken from the Hospital and Palliative Nurses Association website

Advance health care directive and POLST forms:

You can find different versions of advance health care directives in the links below:

Virtual advance care planning workshops

Stanford's 2 Part Virtual Advance Care Planning Workshops- Our Palliative Care Health Education, Engagement, and Promotion program is delivering 2 -part ACP workshops every 3 months!  

Hospice Giving Foundation- Provides regular, free virtual 45 minute advance care planning workshops.  Also provides workshops on the POLST, on starting advance care planning conversations, and on understanding medical decisions like palliative care, CPR, and ventilators.  Click here to register.    

UCSF MERI Center for Education in Palliative Care at Mt. Zion - Providing free virtual monthly 2 part advance care planning workshops.  Those who attend both parts will receive a free book and Go Wish cards!  Click here to register.

Advance health care planning during COVID-19

Be prepared in case of a serious illness

During COVID-19, many wonder about the type of health care they would want if they were to become seriously ill.

This can be difficult. However, thinking about what kind of care you would want if you couldn't make decisions for yourself, helps you and your loved ones. 

In this webinar, Dr. Grant Smith talks about advance care planning.  Advance care planning is planning you do now in case you were to become so sick you could not make health care decisions for yourself.  It is a process all adults can do, and the sooner, the better.  Dr. Smith is joined by Stanford Dr. Winnie Teuteberg, palliative care doctor, to answer questions at the end of the talk.

Webinar disponible también en español.

A note on notary services during COVID 19:

A notary is a person who is approved to witness you signing a statement or contract, so that it becomes a legal document.  If you are not able to have two witnesses sign your advance health care directive, you can have one notary sign the document.

Many notaries can be found within UPS, Postal Annex, and E-Z Mail stores as well.  These are essential businesses and are open to walk-in or to set up an appointment to get advance health care directives notarized.  Mobile notary services may also be available in your area.