Advance Directive

Advance Directive Overview

An advance directive is a legal document that outlines in detail the care that healthcare providers should give to you should you be in unable to speak for yourself. Every state recognizes advance directives, though individual states have different guidelines to use of these documents. Click here for state specific guidelines.

Getting Started

Here's how to ascertain you are treated as you would wish when you are incapacitated. Establish the end-of-life care alternatives at your disposal. Narrow down onto the specific care you would want for yourself. hare your end-of-life decisions with your loved ones and doctor. Lay it down in writing for the sake of clarity.

Though these issues are difficult to talk about, everyone has a strong stand on how they would want to be treated. That is why early advance care arrangement works to your benefit as well as to the benefit of your loved ones and friends. Sunrise Hospice Care Inc. complies with all State and Federal laws regarding advance directives and informs and distributes written information to the patient on his or her right to formulate advance directives.

What are Advance Directives?

Advance directives are documents known as a living will (different than a last will and testament) and a healthcare proxy. Together, they make up "advance directives" in which you:

Clearly state your preferences for the health care you wish to receive, or not receive. Give someone of your choosing the authority to make decisions on your behalf if you are unable to communicate your preferences on your own when decisions must be made.

A Robert Wood Johnson Foundation study found that the vast majority of Americans would prefer to die at home rather than in a hospital or institutional setting, yet only about 30% actually do so. And a national survey by The Conversation Project found that 90% of people know they should discuss their end-of-life care preferences with family and loved ones, but again, only about 30% actually do.

HFA recently coordinated a nationwide community education project, called Being Mortal, to raise awareness of the importance of advance care planning which reached over 60,000. Audience members viewed the Frontline documentary, Being Mortal, and participated in a discussion to learn about prioritizing their end-of-life care wishes and communicating them to loved ones and healthcare providers. Feedback from thousands of people indicate that 97% will now, for the first time, think about and communicate their wishes, and 92% will complete their advance directives.

There is no simple explanation for the great disparity between what people say they want and what they will actually do. But one thing is certain: if you neither discuss nor document your health care preferences, there is at best, only a 50% chance that any choice made on your behalf will reflect your preference if you were unable to communicate your wishes.

Becoming adequately prepared for the time when you may not be able to communicate your wishes for end-of-life care isn't easy. But it's the only way to ensure your wishes are carried out. Preparing someone else to make choices on your behalf will not only give you assurance and peace of mind, but also your loved ones and healthcare providers. We hope the information below will help you will feel more informed about and comfortable with advance care planning and will take the steps to ensure your wishes are carried out, if and when it's needed.

What is Advance Care Planning?

Advance care planning is the process of ensuring your end-of-life care wishes are honored if you're unable to communicate them yourself. Thinking about this type of care isn't easy, but it's the first step in securing the peace of mind that comes with knowing your wishes will be carried out by the people you choose.
Here are three main steps to help you navigate the process:
  • 1) Think carefully about the type of end-of-life care you want and who you would like to carry out your wishes.
  • 2) Discuss your preferences with those who are important to you and will honor your choices, including your healthcare provider.
  • 3) Document your wishes and provide copies to anyone who needs them.

We believe that each step is important, but even if you don't get to Step 3 to complete the documents, we encourage you to at least discuss your end-of-life care preferences with your loved ones and healthcare professionals. Though it may be difficult, we have yet to hear from anyone who regrets having had these discussions. Perhaps the toughest part is actually starting the conversation

We know the conversation can be hard, so we've compiled some resources below that you may find helpful as you navigate the process. Sunrise Hospice Care does not endorse any of these resources, as each person is unique in their beliefs, wishes, and circumstance. We are providing them to you as information that you may or may not decide to use. These links will redirect you from our website:

Why do you need Advance Directives?

Completing advanced directive forms allows your family, loved ones, and healthcare team to share the same understanding of your wishes. It provides you with the reassurance that your wishes are heard, understood, and will be carried out if you are unable to communicate them yourself.

The provision of hospice care is not conditioned upon whether or not the individual has executed an advance directive.

Sunrise Hospice Care will assist the patient/caregiver in the formulation of advance directives.

Sunrise Hospice Care will document in the patient's medical record whether they have or have not executed an advance directive.

Sunrise Hospice Care provides staff and community education on issues concerning advance directives.

During the admission interview, and prior to receiving care, the hospice nurse or social worker provides written information and instruction on advance directives to the patient. If the patient is unable to understand this information, it is given to the patient's legal health care representative or proxy.

The written information given to the patient and or legal representative includes:

a. The hospice's policies on the implementation of the patient's advance directives including any limitations; and

b. A description of the patient's rights under State law, including the patient's right to formulate an advance directive and the right to accept or refuse medical or surgical treatment, including do not resuscitate (DNR) orders.

2. In the patient's clinical record, the hospice nurse or Social Worker documents that the patient has received written information related to advance directives and whether the patient has or has not executed an advance directive.

3. If available, a copy of any advance directive is placed in the patient's clinical record and the patient's wishes, including his or her DNR status, are communicated to members of the hospice IDG to be included in care planning for the patient.

4. If the opportunity to formulate an advance directive is declined at the time of admission, the patient may execute one at a later date. The hospice nurse or the social worker provides the patient with appropriate forms and ensures that they are properly completed.

5. The patient's physician signs DNR orders and a copy is placed in the patient's clinical record, while the original is retained by the patient and is in his or her possession at all times.

6. Education is provided to hospice staff and the community regarding advance directives, advance care planning and patient rights regarding advance directives.

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How do you access Advance Directives?

Advance directives are intended to provide documentation of your healthcare wishes and preferences regardless of where you reside, but the actual documents often differ from state to state. To access California State specific forms, please contact

What should you do with your completed Advance Directives?

Once your advance directives are complete, we recommend that you:

  • 1. Provide a copy to whomever you chose to make decisions on your behalf.
  • 2. Provide a copy to those important to you; loved ones, friends, and physician.
  • 3. Place the documents somewhere easily accessible if needed in an emergency, not locked away somewhere. Consider keeping a copy in the car along with your automobile registration.