Advance Care Planning

Advance Care Planning

Advance Care Planning are your decisions for health care in the future should you be unable to speak for yourself. This is not about old age as a medical crisis can happen at any age! It removes doubt and the need for guessing games when medical care decisions need to be made immediately during a time of crisis.

Selecting a Trusted Person:

This individual will be your voice should you be unable to speak for yourself. This person will have had many discussions with you and will know your decisions and will follow-through with what you have written. They can be either a family member or a friend and over the age of 18. They should be familiar with your values, be physically and emotionally able to serve in this role and be comfortable in a medically setting.

In the State of Arizona, if you do not have an individual designated as your Health Care Power of Attorney, this is the order in which that spokes person for you will be selected:

  1. Spouse
  2. Adult children beginning with eldest child
  3. Parent(s)
  4. If unmarried, Domestic Partner
  5. Sibling(s)
  6. Close Friend

Written Advance Directives:

There are various forms available for this purpose. You may download the forms from the Arizona Attorney General's office here. The office of St Jeanne Jugan to Elders provides a copy of 5 Wishes which is recognized in 44 states including Arizona. The 5 Wishes form also includes a section where information for your decision on spiritual care can be included.

If you chose to use one of the two documents listed above, the document will need to be notarized or witnessed. It is important that the Notary or Witness NOT BE:

  1. Under the age of 18
  2. Related to you by blood, adoption or marriage
  3. Entitled to any of your estate
  4. Appointed as your agent
  5. Involved in providing your health care at the time the form is signed

Once completed and signed distribute copies to you designed person listed to speak on your behalf, all your doctors involved with your health care, your family members, every hospital you go to for out/in patient service. Photocopies of these signed documents are acceptable for all these individuals.

Review your documents:

  1. Every 5-10 years
  2. Change of martial status
  3. Death of selected Power of Health Care Attorney
  4. Change is health status
  5. Disasters (e.g. pandemic)

Have the Conversation with Everyone Important in Your Life:

Many fear having this conversation, but this is an important conversation to have. Plan on how you would like to have this conversation and where. Reassure the love on that this is preparation and planning in the event something should happen. Let them know you have put thought to this plan and that they will be adjusted as time or status progresses. Reassure them this is a plan should opportunity present that you are unable to speak on your behalf and these are your decisions for care.

Please visit The Conversation Project for suggestions on having the conversation

Complete Information Packet with forms can be provided by contacting Patsy Klein at (520) 392-4999 or by email at patsyk@ccs-soaz.org. The complete folder of materials will be sent by U.S. mail to your residence.

Thank you to our grant sponsors:


Service Provider:

How You Can Reach Us:

  • Patsy Klein, M.Ed Program Coordinator

    (520) 392-4999
    (520) 670-0844
    268 W. Adams Street
    Tucson, AZ 85705
  • Deacon Mike Gutierrez

    (520) 670-0853
    268 W. Adams Street
    Tucson, AZ 85705

Documents & Forms:

Locations Available:

    • Pima

Donate Now

Help a child, family, or adult in need.

Donate Now