Estate Planning · Sherman Oaks, CA
Advance Health Care Directives
Decide who may speak for you, and give them a clear plan to follow.
An advance health care directive names the person who may make healthcare decisions for you if you cannot make or communicate them yourself, and records the wishes you want followed. I’m Siena Martinez, and I prepare directives as part of a complete California estate plan.
Siena M. Martinez, Esq.
Founder & President, Siena Law, P.C.
Prepared for clients throughout Greater Los Angeles and Ventura County from Sherman Oaks, with remote estate planning across California.
What it is
What is an advance health care directive?
It is California’s document for healthcare decisions that may need to be made when you cannot make them yourself. While you can make and communicate your own decisions, you continue to do so. The directive is for when that is no longer the case, and it does two jobs.
Siena M. Martinez, Esq.
Founder & President, Siena Law, P.C.
01
Choosing who can make decisions
You name a healthcare agent: the person you want making healthcare decisions on your behalf, within the authority the directive gives them. You can also name alternates in case that person cannot serve.
- Who may decide, and in what circumstances
- Alternates, if your first choice cannot act
- Any limits you want placed on that authority
02
Communicating your healthcare wishes
You can also record instructions: the kinds of care you would or would not want, what matters most to you, and anything else you want the people involved to know.
- Treatment preferences, at a level you are comfortable with
- The values you want to guide a decision
- Guidance your agent and physicians can rely on
Siena M. Martinez, Esq.
Founder & President, Siena Law, P.C.
Why it matters
Planning ahead makes decisions clearer.
Most people have an idea of who they would want speaking for them, and some idea of what they would say. A directive turns those assumptions into something family and healthcare providers can rely on.
It identifies the person with authority to decide, so no one has to guess who should be consulted. It gives that person guidance rather than a blank page. And it does this in advance, when the choices can be made calmly and discussed with the people involved.
Incapacity is not only a question of age. An accident or a sudden illness can affect anyone, which is why a directive belongs in a first estate plan, not only a later one.
Is this for me?
Who should consider an advance health care directive?
Almost every adult, in practice. It is not reserved for older clients or serious illness. These are the situations in which I most often recommend one, and each is ordinary.
01
Adults creating a first estate plan
A directive is one of the core documents, alongside a will or living trust and a financial power of attorney.
02
Married couples and partners
Spouses often assume they can decide for each other. A directive states it clearly, and says who follows if your spouse cannot act.
03
Parents
Someone would need to make decisions for you while also looking after your children. Naming that person in advance is part of planning for them.
04
Adults whose closest trusted person is not their nearest relative
A directive lets you choose a partner, a close friend or one particular family member, rather than leaving that question open.
05
Changed circumstances or preferences
A new relationship, a move, a diagnosis or simply a change of mind can leave an older directive out of date.
06
Anyone facing significant medical treatment
Before a scheduled surgery or during an ongoing course of care, having the document in place settles the practical questions. I address the legal planning; your physicians address the medicine.
Your healthcare agent
Choosing someone to make healthcare decisions for you
This is the central decision in the document. Your agent makes healthcare decisions within the authority the directive gives them, speaks with your physicians, and applies the instructions and wishes you have recorded. Unless the directive says otherwise, that authority generally begins only after a determination that you cannot make your own decisions.
01
Qualities to consider
The right person is not always the nearest relative, and does not need to be the same person who handles your finances.
- Someone you trust to follow your wishes, even under pressure
- Willing to take on the role, and comfortable asking physicians hard questions
- Able to communicate clearly with family and providers
- Likely to be reasonably available when needed
02
Naming an alternate
California’s directive lets you name alternate agents to serve, in order, if your first choice cannot or will not act. That keeps the decision with someone you chose rather than leaving it open.
Talk with the people you name before you sign. An agent who knows what you want is far better placed to act on it.
Your instructions
Giving your agent guidance about what matters to you
Naming an agent answers who decides. Your instructions help with how. The directive can record your preferences alongside the appointment, at whatever level of detail you are comfortable with.
Treatment preferences
Your general wishes about life-prolonging treatment, comfort care and the care you would or would not want, in plain language rather than clinical detail.
Values and quality of life
What a good outcome looks like to you, and the considerations you would want weighed when a decision is not clear-cut.
Other wishes
Matters such as organ donation, your primary physician, or anything else you want the people involved to know.
The directive is not a medical questionnaire. It records the instructions you choose to give, and the conversation with your agent about them matters as much as the words on the page.
Siena M. Martinez, Esq.
Founder & President, Siena Law, P.C.
Scope
What a directive does, and does not, do
Siena M. Martinez, Esq.
Founder & President, Siena Law, P.C.
An advance health care directive can help you:
- Identify the person with authority to make healthcare decisions for you
- Record your healthcare instructions and preferences
- Give your agent, family and providers a clear framework if you cannot make or communicate decisions yourself
It is not the document that manages your financial affairs. An agent under a directive cannot pay your bills, sign for your property or handle your accounts. That authority comes from a separate document.
A common confusion
Healthcare decisions and financial decisions need different planning
Both let someone act for you during your lifetime, and people often use the phrase power of attorney for both. In California they are separate documents with separate jobs, and most complete plans include both.
Healthcare decisions
Advance health care directive
- Names a healthcare agent, and alternates
- Records your healthcare instructions and preferences
- Guides decisions about treatment and care when you cannot decide yourself
- Gives no authority over money or property
Financial decisions
Financial power of attorney
- Names an agent for financial matters
- Covers property, accounts, bills and transactions
- The agent acts within the authority the document sets out
- Gives no authority over healthcare
Siena M. Martinez, Esq.
Founder & President, Siena Law, P.C.
The complete plan
One part of a larger incapacity and estate plan
A directive answers the healthcare question. The rest of the plan answers the others: who manages your finances, what happens to your property, and who carries out your wishes. I draft the documents to work together.
01 Healthcare decisions
Advance Health Care Directive
Who may make healthcare decisions for you if you cannot, and the instructions you want followed.
This page
02 Financial decisions
Financial Power of Attorney
Who may handle financial matters on your behalf, under the terms and in the circumstances the document sets out.
03 Property & continuity
Living Trust
Holds and manages assets during your lifetime and says how they pass afterward, depending on how the plan is structured.
04 Instructions & wishes
Will
Written instructions for your property, the nomination of an executor and the other matters a will addresses.
Keeping it current
When should you revisit your healthcare planning?
A signed directive does not expire on a schedule, but it should still say what you mean. These are the moments that most often call for a fresh look.
Siena M. Martinez, Esq.
Founder & President, Siena Law, P.C.
- A marriage, or the end of one
- A change in an important relationship, or the loss of the person you named
- Your agent is no longer the right person, or is no longer able or willing to serve
- A move, particularly to or from California
- A meaningful change in your health, or in your views about care
- Creating or updating the rest of your estate plan, or many years since you signed
Reviewing does not always mean replacing. Often the document still fits. When it does not, a new directive is signed and the earlier one revoked.
What to expect
What to expect when you work with Siena Law
01
Understand your goals
A conversation about the people in your life, your relationships, your preferences and any concerns about healthcare planning.
02
Choose your decision-maker
Decide whom to appoint as your agent, whether to name alternates, and whether any limits belong on their authority.
03
Document your instructions
I prepare the directive so your choices and preferences are expressed clearly, and review it with you before you sign.
04
Coordinate your estate plan
Make sure the directive works alongside your power of attorney, trust and will, and that the people you named know where to find it.
Siena M. Martinez, Esq.
Founder & President, Siena Law, P.C.
Siena M. Martinez, Esq.
Founder, Siena Law, P.C. · California State Bar No. 351791
Working with Siena
Thoughtful planning for decisions that are personal
A directive is a short document, and it is easy to treat it as a form: fill in a name, sign, put it away. I do not think that is enough. Its value is in the thinking behind it: who you trust, what you would want, and whether the people involved know.
Before founding Siena Law I spent nearly three years in trust and estate litigation, reading documents that were unclear or contradicted one another. I bring that here by drafting instructions that best reflect your actual preferences, and by aligning the directive with your power of attorney, trust, and will.
You work with me directly, from the first conversation to the final signature.
Questions
Health care directive FAQs
Short answers to the questions I hear most. The consultation is where they get longer.
Siena M. Martinez, Esq.
Founder & President, Siena Law, P.C.
What is an advance health care directive in California?
It is the document California law provides for naming a healthcare agent, giving healthcare instructions, or both. It applies to decisions that need to be made when you cannot make or communicate them yourself. While you can, you continue to make your own decisions.
Who should I choose as my healthcare agent?
Someone you trust to follow your wishes, who is willing to serve, and who can communicate clearly with physicians and family under pressure. That person does not need to be your closest relative or the person who handles your finances. Naming an alternate is also sensible in case your first choice cannot act. More on choosing your agent.
When can my healthcare agent make decisions for me?
Unless the directive provides otherwise, an agent’s authority generally begins only after a determination that you lack the capacity to make your own healthcare decisions. Until then, you make your own decisions. It can be drafted differently where there is a reason to.
Can I change my advance health care directive later?
Yes. As long as you have the capacity to do so, you can revoke or replace your directive. A later directive generally revokes an earlier one to the extent the two conflict. When you make a change, let your agent, your physicians and anyone holding a copy know.
Is an advance health care directive the same as a power of attorney?
No. A directive covers healthcare decisions, and the part that names an agent is sometimes called a power of attorney for health care. A financial power of attorney covers financial matters. Neither gives authority over the other, and most complete estate plans include both.
Do I need a directive if I already have a living trust or will?
A clear place to begin
Make your healthcare decisions part of your estate plan
Decide who can speak for you, and give that person meaningful guidance about what you want.
Sherman Oaks office · Remote & in-person meetings throughout California · 805-552-6896