PART 3 OF 4: Executing, Revoking, and Keeping a Directive Current

The formalities that make a directive valid and enforceable.

A directive that is not properly executed may not be honored when it matters. California law sets specific requirements for signing, witnessing, and revoking these documents, along with special rules for individuals in skilled nursing facilities. This article addresses the formalities and the ongoing maintenance a directive requires.

Execution requirements

A California advance healthcare directive must be signed and dated by the individual, and it must be either acknowledged before a notary public or signed by two qualified adult witnesses. Witnesses must personally know you or verify your identity, and there are restrictions on who may serve — your agent may not act as a witness, and at least one witness must not be related to you by blood, marriage, or adoption, and must not be entitled to any part of your estate.

Skilled nursing facility residents

If you are a patient in a skilled nursing facility at the time you execute a directive, California requires an additional signature from a patient advocate or ombudsman. This safeguard is intended to confirm the directive reflects your own wishes.

Revoking or changing a directive

You may revoke the designation of your agent at any time by a signed writing or by personally informing your supervising health care provider. Other provisions of the directive may generally be revoked at any time in any manner communicating intent to revoke. Executing a new directive revokes a prior one to the extent of any conflict. Notably, a divorce or annulment generally revokes the designation of a former spouse as agent unless the directive provides otherwise.

Distribution and access

A directive cannot be followed if no one can find it. Provide copies to your agent and alternates, your physician and any facility where you receive care, and consider keeping a copy accessible to family. Storing the only copy in a safe deposit box is a common and avoidable mistake.

Review periodically

Circumstances change. Review your directive after major life events — marriage, divorce, a death in the family, a significant diagnosis, or a move to another state — and confirm your named agent is still the right person and still willing to serve.

Related documents

A directive works alongside other tools, including a POLST form for individuals with serious illness, which translates treatment preferences into physician orders, and HIPAA authorizations that allow your agent to access medical information. These are separate from, and complementary to, the directive itself.

How West Coast Health Law Can Help

We prepare, execute, and update advance healthcare directives that meet California's formal requirements and coordinate properly with related documents.

West Coast Health Law offers a FREE consultation which you may schedule by clicking the button on our website.

This article is provided for general informational purposes only and does not constitute legal advice or create an attorney-client relationship. Laws change and every situation is different; consult a qualified attorney about your specific circumstances.