An advance health care directive (AHCD) is a legal document that lets you state your medical wishes and name someone to speak for you if you can’t communicate. It helps your doctors and family follow your choices during a serious illness or emergency.

Compassionate lawyer helping client and family understand what are advance healthcare directive options

In California, you can complete a single form to name an agent and record treatment preferences, then sign with either two witnesses or a notary. However, many people confuse an AHCD with a POLST or DNR, or don’t follow California’s signing rules, which can cause delays in care.

Common Mistakes to Avoid

Even with the best intentions, many people make errors when creating an advance healthcare directive that can render it ineffective when it matters most. From confusing it with other documents like a living will or POLST, to overlooking California’s strict signing rules, these missteps often delay or derail care.

Understanding these common pitfalls can help you create a directive that truly protects your wishes and provides clarity for your loved ones and medical team.

They think an AHCD is only for older adults, when planning helps any adult who wants their wishes honored.
They mix up terms: living will, medical power of attorney, POLST, and DNR each do different things.
They don’t follow California’s witness/notary rules, which can make a document unusable.
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They file the form away and forget to share copies or register it, so providers can’t find it when needed.

In this article, you’ll learn how to avoid these pitfalls and make informed choices.

How an Advance Health Care Directive Works in California

Lawyer discussing advance healthcare directive paperwork and notarization with a client in a calm office setting

An advance healthcare directive isn’t just a form, it’s a roadmap for how your medical care should be handled if you can’t speak for yourself. In California, the process is streamlined into a single document that lets you both name a trusted decision-maker and record your treatment preferences.

By completing the form correctly and sharing it with the right people, you can ensure your wishes are honored and avoid the confusion that often arises during medical emergencies.

An AHCD lets you:

name a health care agent (medical decision maker), and
record your treatment preferences (for example, pain control, life-sustaining treatments, organ donation).
California’s unified AHCD covers both roles in one document.

What to do:

Residents of Santa Clarita, CA can use these same statewide rules and forms.

Understanding the difference between AHCD vs. POLST vs. DNR

One of the biggest sources of confusion in advance care planning is mixing up an advance healthcare directive (AHCD) with other medical orders like a POLST or DNR. While they all relate to healthcare decisions, each serves a very different purpose. Knowing how they differ, and when each is appropriate, can prevent serious misunderstandings and ensure your care aligns with both your wishes and your medical situation.

While they all deal with healthcare choices, each serves a unique role at different stages of life or illness:

An AHCD is a legal document where you name an agent and state general preferences; it guides care if you can’t speak.
A POLST is a medical order for people who are seriously ill or frail; it gives current, actionable orders (e.g., CPR, hospitalization).
A DNR is a medical order that specifically declines CPR.
For most healthy adults, an AHCD is the right starting point; a POLST is considered when you have advanced illness.

For most healthy adults, starting with an AHCD is the right approach. A POLST may be added later if advanced illness develops, just be sure both documents remain consistent.

Benefits of Completing an Advance Health Care Directive

Professional consultation about mental medical decision-making and legal planning for future care

Filling out an advance healthcare directive isn’t just a legal step, it’s an act of care for yourself and for the people who may one day need to speak on your behalf. By writing down your wishes and choosing a trusted decision-maker, you remove guesswork and reduce the emotional burden on loved ones during difficult times.

Research shows that advance care planning leads to better end-of-life experiences, higher family satisfaction, and care that aligns more closely with your personal values.

Here’s what you gain when you complete an AHCD:

Peace of mind – You know your preferences are documented and legally recognized, no matter what happens.
Reduced family stress – Loved ones won’t have to make tough choices in the dark; they’ll have clear guidance about your wishes.
Better medical outcomes – Doctors can provide treatment that respects your values instead of defaulting to aggressive measures you may not want.
Improved family well-being – Studies show lower rates of stress, anxiety, and depression in relatives when a directive is in place.
Stronger communication – Having these conversations early builds understanding among family, caregivers, and medical teams.

Ultimately, an AHCD is about making sure your voice is heard, your dignity is preserved, and your care reflects the life you want to live.

Does a healthcare directive need to be notarized?

Whether a healthcare directive needs notarization depends on the state’s rules. In California, you have two options: sign your advance healthcare directive in front of two qualified adult witnesses or have it notarized. Witnesses cannot be your healthcare provider or someone directly involved in your care, and at least one must not be related to you by blood, marriage, or adoption. If you choose the notary option, the notary verifies your identity and signature, ensuring the document is legally valid.

Notarization is often preferred if you want an added layer of legal certainty or if you plan to use an electronic (digital) AHCD, since California requires electronic versions to be notarized. While notarization is not always mandatory, failing to meet the correct witnessing or notarization rules can make the directive unenforceable, leaving your wishes unclear in an emergency.

What is a mental health advance directive?

A mental health advance directive is a specialized type of advance directive that focuses on psychiatric care. It allows you to state your treatment preferences and appoint a decision-maker in the event you are unable to make choices due to a mental health crisis. For example, you can outline whether you prefer certain medications, hospitalization, or specific therapies, and you can designate someone you trust to advocate for those preferences.

These directives are especially important for individuals living with conditions like bipolar disorder, schizophrenia, or severe depression, where periods of impaired judgment may occur. Not every state recognizes mental health advance directives in the same way, so the scope of what you can include and how it is enforced varies. Still, having one in place helps ensure that your values and choices are respected, while providing guidance to both your loved ones and your healthcare providers during challenging times.

How to store healthcare directive for loved ones?

Creating a healthcare directive is only half the job, making sure it’s accessible when needed is just as important. Too often, people complete the document and tuck it away in a drawer, leaving loved ones scrambling to find it during an emergency. The best practice is to provide copies to your chosen healthcare agent, close family members, and your primary doctor. Many people also keep a copy in an easy-to-spot place at home, such as with other important legal or medical paperwork.

In California, you can take an extra step by registering your advance healthcare directive with the California Advance Health Care Directive Registry. This makes it easier for hospitals and providers to confirm your wishes quickly. For added security, consider keeping a digital copy stored on your phone or in a secure online health portal. The goal is simple: your directive should be available at the moment it’s needed most, not hidden away where no one can find it.

Who can witness advance health directive?

In most states, including California, you have the choice to either have your advance health care directive notarized or signed by two adult witnesses. But not just anyone can act as a witness, there are rules to ensure neutrality and prevent conflicts of interest. Generally, witnesses must be over 18, mentally competent, and not directly involved in your medical care. At least one of them usually cannot be related to you by blood, marriage, or adoption, and they should not stand to benefit from your estate.

California law also excludes your healthcare provider or employees of your care facility from serving as witnesses. This is meant to protect you from outside influence and make sure the directive reflects your true wishes. Choosing the right witnesses is essential, because if the requirements aren’t met, the document may not be valid when it’s needed most. For peace of mind, some people opt to use a notary public instead, since that can simplify the verification process and add extra legal certainty.

How to get an advance health directive?

Getting an advance health care directive is straightforward, and in most cases, you don’t need to hire an attorney. In California, official forms are available for free through hospitals, nonprofit organizations, and state health agencies. One well-regarded option is the PREPARE for Your Care form, which is widely accepted and easy to complete. You can also request a copy directly from your doctor’s office, hospital, or even download standardized versions online that meet state legal requirements.

Once you’ve obtained the form, you’ll fill it out to name your healthcare agent and outline your treatment preferences. Then, you must either sign it in front of two qualified witnesses or have it notarized. After completion, share copies with your agent, family, and medical providers, and consider registering it with the California Advance Health Care Directive Registry for quick access during emergencies.

Common questions about an advance healthcare directive

Is an advance health care directive the same as a living will?

Not exactly. “Advance directive” is a broad term. In California forms, you can record treatment wishes (often called a living will) and name a health care agent in one document.

Do I need a notary in California?

You must either sign before two adult witnesses (who meet statutory rules) or sign before a notary. Electronic AHCDs must be notarized.

Where should I file my directive?

Share copies with your agent and doctors, keep one at home, and consider the California Advance Health Care Directive Registry so providers can verify it when needed.

Can I change or cancel my AHCD?

Yes. You can complete a new form and give updated copies to your agent and providers at any time.

When should I update my advance health care directive?

It’s a good idea to review your directive every few years or after major life changes, such as a new medical diagnosis, marriage, divorce, or the death of the person you named as your agent. Updating ensures your document always reflects your current wishes and circumstances.

Is an advance health care directive valid in other states?

Most states will honor a directive created elsewhere, especially if it follows general legal standards. However, because requirements vary, it’s best to complete a new form if you move to another state to avoid any confusion or delays in care.

Take Control of Your Future Today

An advance health care directive is more than a form, it’s your voice when you need it most. By putting your wishes in writing and naming someone you trust, you give clarity, peace of mind, and protection to both yourself and your loved ones. Don’t wait until a crisis forces others to decide for you. If you’re in Santa Clarita, CA, and want guidance on creating or updating your directive, the Law Offices of Andrew Cohen is here to help. Call (661) 481-0100 today and take the first step toward securing your future with confidence.

Advance Healthcare Directive

What is an advance healthcare directive