Published on August 09, 2020

Planning ahead for yourself and your loved ones

A man and a woman writing on pieces of paper

When John arrived at the Emergency department at Community Hospital of the Monterey Peninsula, suffering from advanced lung disease, his inability to breathe had become so critical that the only way he could get enough oxygen was to intubate him — insert a breathing tube in his throat and put him on a ventilator.

Ideally, the team caring for him would get his permission first. But John, at 85, had dementia and couldn’t understand the question; and he had no one with him who could speak for him. Anticipating that a day like this might eventually come, John had planned ahead. Eleven years earlier, he had prepared an advance directive for healthcare, and there were copies at both the nursing home where he lived and at Community Hospital. His instructions were perfectly clear: “I do not want my last days spent with a tube down my throat or a feeding tube.”

“The patient’s wishes were honored,” says pharmacist Dharma Naidu, a member of the Palliative Care team at Community Hospital. “Care was prescribed in the most appropriate manner,” Naidu says, focused on making John comfortable until he passed away.

Naidu recalled a case that followed a different path, when no advance directive could be found and the patient’s children disagreed on how their mother would want to be treated after a debilitating stroke.

“Do everything possible,” one son said.

“She did not want to be a burden and said that life wasn’t worth living if she couldn’t do the things she loved,” said the daughter.

After more than two weeks and numerous medical interventions, their mother died. The siblings were left with their grief, and their uncertainty about decisions they had made.

Having an advance directive doesn’t make losing a loved one easy, but it can make it easier by taking guesswork out of decision-making at a critical and emotional time, says Joy Smith, RN, who leads workshops for Community Hospital on preparing advance directives.

"Advance healthcare planning is a gift to yourself and to those who care about you."

— Joy Smith, RN

Community Hospital offers free two-hour workshops online to:

  • Select the best document to record their wishes
  • Update advance planning documents they already have
  • Receive expert coaching to clarify wishes
  • Submit the completed documents into their Community Hospital medical record

Advance planning FAQs

What is advance care planning?

  • The process of thinking about and planning for your wishes for care should you have a serious illness
  • The selection of a medical decision-maker(s) who will make decisions about your care if you are unable to do so yourself
  • A lifelong process that changes as you age and experience changes in your health

What is an advance healthcare directive?

  • A specific document that legally appoints a medical decision-maker(s) for you
  • A document that describes your wishes for care if you are seriously ill
  • A legal document that is part of your medical record
  • A document that is updated as you age and experience changes in health

Who needs copies of your advance healthcare directive?

  • Your medical decision-maker(s)
  • Your primary care doctor and specialists
  • Community Hospital of the Monterey Peninsula, or any hospital where you receive care

Advance healthcare planning classes

Learn more and find a schedule of upcoming classes.

You can also find forms online at

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