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Comprehensive Guidance on DNR Orders for Dana Point Residents
Planning for medical emergencies is an essential part of estate planning in Dana Point, and Do Not Resuscitate (DNR) orders play a distinct role in directing care when a person cannot speak for themselves. A DNR order tells medical personnel whether you want cardiopulmonary resuscitation or other resuscitation measures performed if your heart or breathing stops. Many Dana Point residents include DNR orders as part of a broader healthcare plan to ensure their wishes are clear and honored. LA Estate Plans helps clients create DNR documents that fit their medical preferences and comply with California requirements so family and medical teams have reliable guidance.
When a medical crisis occurs, having a properly documented DNR order reduces uncertainty and protects personal healthcare decisions. In Dana Point, a DNR is often paired with an advance directive and a designated decision-maker to form a cohesive plan that covers a range of medical situations. Preparing these documents ahead of time prevents confusion during emergencies and relieves families from having to make contested decisions under stress. LA Estate Plans offers focused assistance in preparing DNR orders and related healthcare documents, helping clients understand how each piece fits into a full advance care plan tailored to their values and medical goals.
Why DNR Orders Matter for Healthcare Planning in Dana Point
A DNR order provides a clear, legally recognized instruction about whether resuscitation should be attempted in the event of cardiac or respiratory arrest. For many people, this clarity ensures that emergency medical teams and hospital staff act in a way that aligns with the individual’s health goals and personal values. In Dana Point, having a DNR can prevent unwanted aggressive interventions that may not improve quality of life. It also reduces stress for family members who otherwise might face urgent decisions without a clear statement of the patient’s wishes. Proper documentation and communication are central to making a DNR effective and reliable.
About LA Estate Plans and Our Dana Point Practice
LA Estate Plans serves Dana Point and the surrounding Orange County communities, focusing on wills, trusts, and probate matters along with advance healthcare planning such as DNR orders. Our practice helps individuals and families navigate legal forms, understand California protocols, and create documents that reflect their preferences for medical care. We emphasize clear communication, careful document preparation, and practical steps to make sure your DNR order is recognized by medical providers. Clients may call 310-634-1006 to arrange an initial conversation about their DNR needs and how those directives fit within a broader estate plan.
Understanding How DNR Orders Function in California Medical Care
A Do Not Resuscitate order is a focused medical directive that instructs emergency responders and hospital personnel not to initiate cardiopulmonary resuscitation if a person’s heart stops or breathing ceases. In California, DNR orders must be properly documented to be effective in clinical settings. That often means completing the required forms and ensuring the order is placed in a visible and accessible location for healthcare teams. Knowing the legal framework and the situations where a DNR applies helps individuals make informed choices and ensures their preferences are communicated clearly to those who will make medical decisions.
DNR orders are most effective when they are part of a coordinated advance care plan that includes a living will or other directive and a designated decision-maker to speak on the patient’s behalf if needed. Combining these documents reduces the likelihood of conflicting instructions and provides a consistent approach for doctors and family members. In Dana Point, integrating a DNR into an estate plan can streamline the process of making healthcare decisions during emergencies, provide peace of mind for the individual, and give family members guidance that matches the person’s documented wishes.
What a DNR Order Is and When It Applies
A DNR order is a specific instruction to medical personnel to withhold cardiopulmonary resuscitation and related resuscitation measures in the event of cardiac or respiratory arrest. It does not restrict other types of medical care that may be appropriate, such as pain relief or comfort measures. For a DNR to be followed, the order must be documented and recognizable by treating clinicians. Understanding the scope of a DNR helps individuals decide if this limited instruction aligns with broader healthcare goals and how it interacts with other documents like living wills or healthcare proxies in California.
Essential Components and the Process for Establishing a DNR Order
Key elements of a valid DNR order include a clear identification of the patient, explicit language stating the preference not to receive CPR, and appropriate signatures or medical documentation as required by California law. The process typically involves a discussion with a medical provider to confirm the person’s wishes and complete the necessary form, followed by distribution of copies to the treating physician, the named decision-maker, and family members. Proper witnessing or physician verification may be required for the document to be acted upon reliably in emergency situations.
Key Terms to Know When Planning a DNR Order
Familiarity with common terms such as advance directive, healthcare proxy, and life-sustaining treatment helps make DNR planning more effective. Each term identifies different aspects of healthcare decision-making and clarifies roles, procedures, and types of medical interventions. Understanding these definitions ensures conversations with medical staff and legal advisors are productive, and helps families follow instructions without guesswork. For Dana Point residents, knowing the vocabulary around DNR orders makes it easier to prepare documents that are recognized by local hospitals and emergency responders.
Advance Directive
An advance directive is a written statement of a person’s preferences for medical care in the event they cannot speak for themselves. It may include instructions about life-sustaining treatments, preferences for comfort care, and designation of a decision-maker. The advance directive serves as a guide for doctors, nurses, and the person appointed to make healthcare decisions. When used alongside a DNR order, an advance directive provides broader guidance about treatments and values, giving medical teams and family members greater clarity about what matters most to the patient.
Life-Sustaining Treatment
Life-sustaining treatment refers to medical interventions that prolong life when a person’s body has stopped functioning normally. Examples include mechanical ventilation, dialysis, and cardiopulmonary resuscitation. A DNR specifically addresses CPR and similar resuscitative efforts, but decisions about other life-sustaining treatments are often documented in a living will or advance directive. Understanding how these treatments differ and when they may be appropriate helps individuals set boundaries for care that align with their comfort, values, and medical goals.
Healthcare Proxy
A healthcare proxy is an individual appointed to make medical decisions on someone else’s behalf if that person becomes unable to decide for themselves. The proxy’s responsibilities include speaking with healthcare providers, reviewing the patient’s written instructions, and making choices consistent with the patient’s stated preferences. Selecting a proxy involves choosing someone who understands your values and who is willing to carry out your wishes. Clear communication with the chosen proxy and distribution of documents helps avoid confusion during urgent medical situations.
Cardiopulmonary Resuscitation (CPR)
Cardiopulmonary resuscitation, commonly called CPR, is an emergency procedure designed to restore heartbeat and breathing through chest compressions, rescue breaths, or automated devices. A DNR order instructs medical personnel not to perform CPR in the event of cardiac or respiratory arrest. Deciding whether to include a DNR in an overall care plan depends on a person’s values, health status, and the likely outcomes of resuscitation. Discussing CPR with medical providers helps individuals make informed choices that reflect their wishes for emergency care.
Comparing DNR Orders with Other Advance Care Documents
Several legal tools can guide medical decision-making, and each serves a particular purpose. A DNR focuses narrowly on resuscitation, while a living will or advance directive offers broader instructions about life-sustaining treatments and comfort-focused care. A healthcare proxy appoints a person to interpret and implement those wishes when the patient cannot. In Dana Point, combining a DNR with other documents creates a coordinated plan that tells medical teams when to withhold CPR and how to approach other treatments. This layered approach reduces ambiguity and helps ensure medical care aligns with personal preferences.
When a Standalone DNR May Be an Appropriate Choice:
Clear Preference to Avoid Resuscitation
A standalone DNR can be appropriate for someone whose primary concern is to avoid cardiopulmonary resuscitation in the event of cardiac or respiratory arrest, without addressing broader treatment preferences. If a person’s primary goal is to prevent the initiation of resuscitative measures while leaving other medical decisions open, a DNR provides focused clarity. This approach minimizes paperwork and delivers a direct, actionable instruction for emergency responders and hospital staff in Dana Point, while still allowing for later additions of other advance directives if broader guidance becomes desirable.
Immediate Recognition in Emergency Settings
Because a DNR order is a short, well-known instruction, it is often immediately recognized by emergency medical teams and hospital personnel, making it effective in urgent situations where quick decisions are necessary. For individuals who want a single clear instruction about resuscitation, a DNR can be the simplest way to communicate that preference. Ensuring the order is visible to responders, providing copies to medical providers, and informing your designated decision-maker helps the DNR be followed reliably when every moment counts.
The Value of a Broader Advance Care and Estate Plan:
Addressing Multiple Treatment Scenarios
A comprehensive plan that includes a DNR, living will, and healthcare proxy covers more possible medical scenarios than a DNR alone, allowing a person to express preferences about a variety of life-sustaining treatments and comfort measures. This broader approach helps ensure consistent decisions across situations that may not be addressed solely by a DNR, such as the use of ventilators or feeding tubes. For many Dana Point residents, documenting multiple preferences reduces ambiguity and gives medical teams clear direction about how to proceed beyond resuscitation.
Reducing Conflicts Among Family and Caregivers
Combining documents and naming a decision-maker helps reduce disagreements among family members by providing written instructions and a designated person to carry them out. When wishes are clearly documented and shared, family members and clinicians can follow a single plan rather than debating options during stressful moments. This clarity is especially valuable in Dana Point where families may be making swift decisions in hospitals or care facilities. Properly drafted and distributed documents can ease emotional burdens and guide care in a way that reflects the patient’s values.
Benefits of Combining a DNR with a Full Advance Care Plan
A combined approach ensures that resuscitation preferences are recorded while also providing instructions for other medical treatments, appointing a decision-maker, and clarifying comfort care priorities. This thorough planning reduces the risk of conflicting directives and makes it easier for healthcare providers to follow instructions that reflect the person’s overall goals. For Dana Point residents, an integrated plan can streamline communication with local hospitals and long-term care facilities by consolidating important decisions in accessible documents.
In addition to improving clarity for medical teams and family, an integrated plan supports legal compliance with California requirements, which increases the chances that providers will honor the patient’s preferences. Regularly reviewing and updating these documents maintains their relevance as health conditions or personal values evolve. Sharing copies with doctors, the healthcare proxy, and family members strengthens recognition and ensures that the individual’s voice continues to guide care in critical moments.
Greater Clarity for Medical Teams and Loved Ones
Clear, written instructions limit confusion for physicians, nurses, and family members when time is limited and decisions matter. A DNR combined with complementary documents gives caretakers a consistent reference about the patient’s wishes and helps ensure responses align with those wishes. When everyone has access to the same information, care teams can act quickly and family members are spared the burden of guessing. For Dana Point families, this clarity often leads to more respectful and coordinated care in emergency and end-of-life situations.
Stronger Legal Compliance and Practical Protection
Ensuring documents meet California standards for form and execution makes it more likely that healthcare providers will accept and follow them. Properly prepared directives that include required signatures or medical verification reduce administrative obstacles and help avoid disputes. Having a distribution plan so the DNR and related directives are in the hands of the appropriate parties further increases their effectiveness. A well-maintained set of documents supports both medical decision-making and legal recognition when it matters most.
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Practical Planning Tips for DNR Orders in Dana Point
Begin Planning Early and Communicate Your Wishes
Start conversations about resuscitation preferences well before a medical crisis occurs, and be open with family members and your chosen decision-maker about what you want. Early planning gives you time to consider how a DNR fits with other healthcare documents and to make thoughtful choices. Communicating preferences reduces misunderstandings and ensures that those close to you know where to find important forms. Making this a part of routine estate planning in Dana Point helps ensure your healthcare priorities are documented and respected when they are needed most.
Keep Your Documents Accessible and Up to Date
Coordinate with Medical Providers and Your Designated Decision-Maker
Discuss your DNR order with the medical professionals who know your health history so they can confirm the language and procedures required for recognition in clinical settings. Involving your chosen decision-maker in these conversations ensures they understand your reasons and can advocate on your behalf if necessary. Coordinating in this way helps align clinical practice with personal wishes, and it supports smooth communication between hospitals, outpatient providers, and family members in Dana Point when care decisions must be made quickly.
Reasons to Put a DNR Order in Place
People choose DNR orders for various reasons, including a desire to avoid invasive resuscitation that may not improve quality of life, to keep control over emergency interventions, and to relieve families of the burden of making urgent decisions without guidance. For those with serious chronic conditions or advanced age, a DNR can align emergency responses with personal values and medical goals. By documenting preferences in advance, individuals in Dana Point ensure their wishes are clear to clinicians and loved ones at critical moments.
Another reason to consider a DNR is to reduce the risk of interventions that would prolong suffering or conflict with long-term care objectives. A DNR works alongside other directives to form a cohesive plan that communicates preferences about the continuum of care. Preparing these documents ahead of time supports smoother interactions with hospitals and emergency responders, helps preserve dignity in medical care, and prevents the confusion that may arise if family members disagree during emergencies.
Common Situations When a DNR Order Is Particularly Relevant
DNR orders are commonly used by people with advanced chronic illnesses, those approaching the later stages of life, or individuals who prioritize comfort-focused care over aggressive interventions. They are also appropriate for people who want explicit instructions about resuscitation but prefer to leave other treatment choices flexible. In each case, documenting a DNR helps ensure that emergency teams follow the patient’s resuscitation preferences and that family members have clear guidance about how to proceed in a sudden medical emergency.
Managing Chronic Illness
For people living with chronic medical conditions, a DNR can be part of a plan to avoid treatments that may be unlikely to improve long-term outcomes. It allows the person to steer emergency responses toward their goals of care and away from measures that may not align with those goals. Including a DNR alongside other directives helps clarify preferences for ongoing treatment decisions and ensures that medical teams have written instructions to follow during urgent events, reducing guesswork for family members and clinicians alike.
Planning for Advanced Age
Older adults often consider DNR orders as a way to ensure their resuscitation preferences are followed during unexpected health events. When placed within a broader estate and healthcare plan, a DNR reflects the person’s priorities about quality of life and the types of interventions they wish to avoid. By documenting these wishes and discussing them with family and care providers, older residents of Dana Point can reduce the burden on loved ones and ensure that medical choices reflect their values and desired level of intervention.
Care for Terminal Conditions
Individuals facing terminal illnesses frequently use DNR orders to focus care on comfort, symptom relief, and quality time rather than invasive resuscitative measures. A DNR clarifies that the priority is comfort-focused or palliative care if the heart or breathing stops. Combined with other directives that address pain management and supportive care, a DNR helps ensure medical teams and family members follow consistent instructions that align with the patient’s goals during the final stages of illness.
We Are Here to Support Your Healthcare Decisions in Dana Point
Why Choose LA Estate Plans for Your DNR Order Needs
Choosing a law practice to help with DNR planning means working with people who understand the forms and clinical context in which those documents operate. LA Estate Plans focuses on clear document drafting and practical steps so directives are recognized by hospitals and emergency teams in California. Our approach centers on detailed preparation, careful review, and ensuring that your instructions are documented in a way that reflects your preferences and meets legal requirements in Dana Point and Orange County.
Clients receive individualized attention to make sure their DNR orders and accompanying directives reflect their values and medical considerations. We help clients name a decision-maker, place the DNR in the appropriate medical records when applicable, and advise on distributing copies to the right people. This personalized process helps reduce uncertainty for families and improves the chances that medical staff will follow the patient’s documented wishes during emergencies.
Beyond initial drafting, we assist with periodic reviews and updates so your DNR and other advance directives remain current as health conditions or personal preferences change. We also offer guidance on how to present documents in clinical settings and what steps to take to ensure accessibility. For residents of Dana Point, these practical measures help maintain legal validity and provide peace of mind that healthcare wishes are documented and reachable when they are most needed.
Contact LA Estate Plans to Discuss Your DNR Order Today
How LA Estate Plans Manages the DNR Planning Process
Our process for preparing DNR orders begins with conversation and information gathering, followed by careful drafting and verification to meet California requirements. We make sure the language is clear, that necessary signatures or medical confirmations are obtained, and that copies are distributed to the right clinical and family contacts. We also advise clients on steps to take in hospitals or with emergency responders to maximize recognition of the DNR. This thorough approach helps ensure instructions are practical and actionable when needed.
Step 1: Initial Consultation and Information Gathering
The first stage focuses on understanding your healthcare goals, personal values, and medical background so the DNR and related documents reflect your wishes. We will discuss scenarios where resuscitation might be considered, clarify what a DNR covers, and identify any other directives you may want to include. Gathering this information ensures documents are tailored to your situation and that designated decision-makers understand the decisions they may be asked to make.
Discussing Your Healthcare Goals and Priorities
During the initial meeting, we explore your preferences about emergency interventions, long-term care goals, and priorities for comfort versus aggressive treatment. These conversations help shape a DNR and complementary directives that reflect your values. Clear communication at this stage also helps confirm whether a standalone DNR is appropriate or if a broader set of documents is recommended for your circumstances in Dana Point.
Reviewing Medical History and Contacting Providers as Needed
We review relevant medical history and, when appropriate, coordinate with your healthcare providers to confirm how a DNR would be documented and recognized in clinical settings. This step helps ensure the form is completed in the proper manner and that medical staff understand its intent. Communication with doctors and care teams supports a smooth transition of the document into medical records when that is desired and permitted.
Step 2: Drafting Documents and Legal Review
Once preferences are established, we prepare the DNR order and any additional advance directives, carefully reviewing each document for clarity and compliance with California requirements. The drafting process includes ensuring the language used is actionable and understandable to medical personnel, and that any required physician involvement or witnessing is accounted for. Our review aims to minimize ambiguity and make the directives readily usable by healthcare teams.
Preparing DNR Forms and Complementary Advance Directives
We create the specific DNR documentation and, if desired, accompanying directives like a living will and healthcare proxy appointment. These documents work together to express resuscitation preferences, broader treatment wishes, and designate someone to decide on behalf of the patient. Drafting each document with consistent language helps prevent conflicts and gives a clear roadmap for care in emergency and non-emergency settings.
Confirming Legal Requirements and Medical Verification
Certain DNR forms may require physician verification or particular signatures under California law to be enforceable. We help clients understand which verifications apply and assist in arranging any necessary medical confirmations or witnessing. Ensuring legal requirements are met increases the likelihood that hospitals and emergency responders will recognize and honor the document when the need arises.
Step 3: Execution, Distribution, and Implementation
After documents are finalized, we assist with proper signing procedures and advise on distributing copies to physicians, the designated decision-maker, and family members. We also recommend practical steps to make the DNR accessible to emergency responders, such as placing copies with primary care records or informing local medical teams. This phase ensures that the directives you prepared are more likely to be located and followed in urgent situations.
Assistance with Signing, Witnessing, and Documentation
We guide clients through the signing process to make sure required witnesses or medical verifications are in place, and that the completed forms meet procedural standards. Proper execution reduces chances of rejection by medical facilities and helps avoid last-minute disputes. Our goal is to leave clients with fully executed documents that medical personnel can rely upon when making urgent care decisions in Dana Point hospitals and emergency settings.
Sharing Documents with Providers, Caregivers, and Family
To maximize the effectiveness of a DNR order, we recommend sharing copies with your primary care doctor, any specialists, family members, and the person named as your healthcare proxy. Making sure these parties know where to find the documents and understand their role helps ensure that the patient’s instructions are recognized and followed. We also provide guidance on updating records and maintaining copies so the directives remain current and available when needed.
The Proof is in Our Performance
Frequently Asked Questions About DNR Orders in Dana Point
What is a DNR order and when is it used?
A Do Not Resuscitate order is a medical instruction that tells healthcare providers not to perform cardiopulmonary resuscitation if a patient’s heart stops or they stop breathing. It applies specifically to resuscitation measures and is intended for situations where the individual does not want emergency resuscitation attempted. A DNR does not inherently stop other forms of medical care, such as comfort measures or treatment for reversible conditions, unless those are also addressed in accompanying directives. Knowing the narrow scope of a DNR helps individuals decide whether it fits their goals for emergency care. In Dana Point, creating a valid DNR involves documenting your wishes in a format recognized by California medical providers and ensuring the order is accessible to treating clinicians. It is often most effective when combined with additional advance directives and a named decision-maker so medical teams and family members have comprehensive guidance about broader treatment preferences beyond resuscitation.
How do I create a legally valid DNR order in California?
To create a legally valid DNR in California you typically need to complete the appropriate form and obtain any required confirmations from a medical provider. The exact process can vary depending on whether the DNR will be followed in an outpatient setting, a long-term care facility, or in the hospital. Ensuring the document contains clear patient identification and an explicit instruction regarding CPR is essential. The form should be signed or verified in the manner required by the administering provider to make it actionable in emergencies. Working with a legal advisor or discussing the order with your doctor can help you understand the practical steps needed to integrate the DNR into your medical records. Distributing copies to your physician, designated decision-maker, and family ensures the order is accessible when emergency responders or hospital staff need to act quickly.
Can I change or revoke my DNR order after it is signed?
Yes, you can change or revoke a DNR order at any time as long as you have the mental capacity to do so. Making changes typically involves completing a new document or clearly communicating the revocation to your healthcare provider and updating any records where the original DNR is kept. It is important to inform family members and the person you named to make decisions on your behalf so they are aware of the change and can act accordingly in an emergency. Because a revoked or updated DNR may not be visible to all treating clinicians immediately, it is recommended to replace physical copies and confirm that your primary care provider and any treating facilities have the most current version. Prompt and thorough distribution of updated documents helps avoid confusion during urgent medical situations.
How does a DNR order differ from a living will?
A DNR order specifically instructs medical personnel not to perform CPR or other resuscitation methods in the event of cardiac or respiratory arrest. A living will or advance directive covers a broader range of medical treatment preferences, specifying wishes about life-sustaining therapies, feeding tubes, ventilators, and other interventions when a person cannot communicate. While a DNR addresses a narrow, urgent decision, a living will provides wider guidance across different medical situations and stages of illness. Both documents can work together to provide comprehensive direction. A living will explains broader goals of care, while a DNR gives immediate instructions for resuscitation. Combining these documents and appointing a decision-maker helps ensure consistency in medical decision-making and better compliance by healthcare providers.
Who should I name as my healthcare proxy?
When choosing a healthcare proxy, select someone who understands your values, communicates well with family, and is willing to make decisions aligned with your wishes. This person should be trusted to advocate for your medical preferences and able to handle discussions with clinicians during stressful times. It is also helpful if the chosen individual is available and able to travel to meetings with medical teams when necessary. Discuss your preferences with the person you name so they clearly understand your goals for care, including any DNR or living will provisions. Providing them with copies of your documents and guidance about your priorities reduces uncertainty and equips the proxy to represent your wishes effectively when it matters most.
Will hospitals and emergency medical personnel honor a DNR order?
Hospitals and emergency medical personnel generally honor properly documented DNR orders that meet the facility’s or jurisdiction’s requirements. Recognition depends on the form’s validity, whether the document is properly executed, and whether medical staff can access or verify the order quickly during an emergency. Ensuring the DNR is placed in your medical record or carried in an accessible location increases the likelihood it will be followed. Because practices can vary, coordinating with your primary care physician and local hospitals in Dana Point to confirm procedures for recognizing and filing DNR orders helps avoid misunderstandings. Providing copies to family members and the designated decision-maker further supports prompt recognition by treating teams.
What forms or signatures are required for a DNR in California?
Required forms and signatures for a DNR in California can depend on the setting and the healthcare provider involved. In many cases, a physician’s confirmation or signature is required to make the order effective in a clinical context. Some settings may also require additional documentation or a specific state form. Ensuring that the completed form includes clear patient identification and explicit refusal of resuscitation helps medical staff act in accordance with your wishes. Consulting with your physician and a legal advisor can clarify which signatures or verifications are necessary for your situation. Obtaining the required confirmations and keeping copies in accessible locations helps the document be recognized by hospitals, emergency responders, and care facilities.
How should I share my DNR order with family and doctors?
You should share your DNR order with your primary care physician, any specialists who manage ongoing care, the person you named as your healthcare proxy, and close family members. Providing physical copies and confirming that your medical providers have the order in your chart increases the likelihood it will be honored during an emergency. Make sure all key contacts know where to find the document and understand its implications to prevent confusion. Regularly review and redistribute the document whenever you make changes. Communicate updates directly to providers and family members, and consider keeping a wallet card or other visible notice indicating that a DNR exists and where to locate it quickly in an emergency.
Does a DNR order affect other types of medical care?
A DNR order addresses resuscitation specifically and does not automatically withdraw other medical treatments. Other types of care, including medications, wound care, or treatments for reversible conditions, may continue unless they are specifically addressed in a living will or other directive. Understanding the limited scope of a DNR helps clarify which medical decisions remain open and which require additional documentation to direct care in alignment with your preferences. To ensure comprehensive guidance, consider pairing a DNR with a living will and naming a healthcare proxy. This combination provides clear instructions about resuscitation and broader treatment preferences so medical teams and family members have a consistent plan for different clinical situations.
How can LA Estate Plans help me with DNR planning in Dana Point?
LA Estate Plans assists Dana Point residents by explaining California requirements for DNR orders, drafting clear and actionable documents, and advising on how to integrate those orders with other advance directives. We help clients identify the documents that best reflect their goals, prepare required verifications or signatures, and provide guidance on distributing copies to medical providers and family members to improve recognition and compliance. Our support also includes periodic reviews and updates to documents as circumstances change, and practical advice on how to present these directives in clinical settings. To discuss DNR planning or schedule a consultation, call our office at 310-634-1006 and we will help you take the next steps toward documenting your healthcare wishes.