San Francisco Advance Health Care Directives and Living Wills

Start with what has changed

Set aside the existing directive and identify what has changed since you prepared it. That might include a change in your health, a new understanding of a treatment option, or a shift in what matters most to you. The practical question is whether your written instructions still express your current wishes.

Rather than beginning with document terminology, describe your preferences in plain language. For example, you might want to clarify which outcomes or circumstances matter most to you. This is a preparation exercise, not medical advice; questions about treatment choices belong with your health-care professionals.

• Note which statements still reflect your wishes and which feel incomplete or outdated.
• Write down questions you want to discuss with a health-care professional.
• Bring the existing directive so you can compare its actual wording with your current thinking.

Separate treatment instructions from choosing a decision-maker

An advance health care directive can express your health-care wishes and identify someone to make health-care decisions. Those are related but distinct functions: written instructions communicate your preferences, while naming a person addresses who may make decisions. This page focuses on the instructions, not on selecting an agent.

If your main concern is who should make decisions, treat that as a separate planning question. If your concern is that your wishes have changed, concentrate on whether the directive’s written health-care instructions still describe them. A financial power of attorney has a different role: it concerns financial decisions, not health-care preferences.

Make the document useful to the people who may need it

Preparing a directive and keeping it accessible are separate practical tasks. A document that accurately reflects your wishes may still be difficult for others to use if they do not know it exists or cannot locate it when needed. Consider who should know where the current document is kept and how they can find it.

You can also distinguish the document itself from information about an executed directive in a registry. Registration is not the same thing as preparing and keeping the relevant documents accessible. Think through both questions: whether the written instructions remain current, and whether the people who may need them can find the document.

• Gather the directive you currently have and any related planning papers.
• Decide whom to tell about the document’s location.
• Keep your own copy in a place you can identify and access.

Choose a practical next step

If the document still reflects your preferences, your next step may be to focus on access and make sure the relevant people know where it is. If it no longer reflects them, note the passages or topics you want to revisit and seek guidance about how to bring the document in line with your current wishes. Avoid assuming that simply locating a registry entry changes the instructions in the document.

Codi M. Dada Law Office P.C. has one in-person office in Novato and provides virtual services throughout California, including San Francisco. To prepare for a planning discussion, bring your current directive and a short list of what has changed and what you want the written instructions to communicate.