House Calls runs every other Saturday. Today's column is written by Molly Padilla, registered nurse at Sutter Coast Hospital and RN case manager for Home Health.

Have you ever thought about the type of health care you would want if you were not able to speak on your own behalf?

Who would you want to make decisions for you? In the event that you were terminally ill, would you want treatment that may prolong your life even if it caused great discomfort? Or would you rather receive treatment that could help you remain comfortable but may shorten your life?

It is important to carefully reflect what your wishes are for health care under these circumstances and then talk with your family and health care providers about your wishes. We all have different beliefs and ideas about what is right for us and it is good to share your preferences with people you are close to and trust.

Sometimes this is a difficult discussion for your loved ones, but let

them know it is important to you. Facing a serious illness is

stressful, especially when life and death decisions need to be made. You

want your loved ones and health care providers to know what your wishes

are if these circumstances occur, and they should feel confident that

they are making decisions that best represent your wishes.

An advanced directive is a legal document recognized by the state of

California that helps you communicate your wishes if you are unable to

do so.

First it allows you to designate a primary and secondary person to

have the legal power to make decisions on your behalf if you are unable

to do so. It also allows you to write down what medical care you want if

you are unable to communicate. You can state wishes like whether or not

you would want IV fluids, blood transfusions, feeding tubes and CPR.

The advanced directive does not go into effect unless you are unable

to make decisions for yourself (for example - you are unconscious or in a

coma). It can never be used to substitute your own judgment if you are

able to make decisions.

You can change or revise your advanced directive at anytime. It is

recommended that you review it each year and whenever you have an

illness or change in health status. Remember to give a copy to your

doctor and have an extra copy in case you are hospitalized.

You can pick up an advanced directive form at the front desk at

Sutter Coast Hospital. When filling it out it must be signed by two

witnesses who are not health care providers, or be notarized.

When you have an advanced directive in place you can be reassured

that your health care providers will know who can make decisions for you

if you are unable to do so and that whomever you designate to make

decisions for you, will know what your wishes are.

Remember, talking about what your wishes are if you had to face a

life threatening illness is difficult, and your loved ones may want to

avoid this uncomfortable subject. However if faced with a crisis, your

loved ones will be able to follow your wishes if you have communicated

what type of medical care you want with them.

Having an advanced directive and talking with your family about this is the best way to have your wishes honored.

Email suggestions for future House Calls columns to Beth Liles at Sutter Coast Hospital,