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Many people are confused about whether they need an advance health care directive (AHCD) or Physician Orders for Life-Sustaining Treatment (POLST) for incapacity planning.  Only individuals with a very serious illness who may not survive for a long time need a POLST.  However, we recommend that any person over the age of 18 — healthy or ill — have an advance health care directive.   A POLST is not a substitute for an advanced health care directive.  For a chart on how the POLST and advance health care directives work together, click here


The POLST document in California is typically bright pink so it is easily recognizable.  This form gives directions to treatment orders such as cardiopulmonary resuscitation (CPR), medical interventions, and artificially administered nutrition.  In California, a doctor, nurse practitioner or physician assistant must sign it.  Thus, as a medical order, healthcare professionals must follow its directions in a medical emergency.  The patient, or other legally recognized decision-maker, also signs it.  Individuals who need a POLST should also have an advance health care directive.

The advance health care directive (AHCD) is a document that allows individuals to express their health care wishes, including end of life wishes.  In an AHCD, a patient can select an agent to decisions when the patient is unable to do so, or if the patient prefers, another person to make health care decisions.  Many AHCDs provide for donation of body parts as well.  Some AHCDs designate whether the patient wants to be resuscitated.  Advance health care directives may direct the agent to carry out specific directions for disposition of body parts, where the patient prefers to live when ill, or any other issue related to health care decisions.  Every person regardless of whether they are sick or healthy over the age of 18 should have an AHCD.

Need an AHCD?

Contra Costa Senior Legal Services provides free advance health care directives to in our office and at clinics in Pleasant Hill and Concord.  For more information, please call 925-609-7900.