We like to think that we will always be capable of making our own healthcare decisions. Sometimes, however, it doesn’t work like that. A stroke, a car accident, Alzheimer’s disease—any number of circumstances might limit or take away a person’s immediate ability to make healthcare decisions.
Fortunately, you have the power to think about and plan for such situations. April 16 is the annual Healthcare Decisions Day, a good reminder to make your wishes and plans official. There are two types of legal documents that are referred to as advance directives: healthcare appointments and healthcare directives.
A healthcare appointment is also called a durable power of attorney for healthcare or a healthcare proxy. This is a document that lets you give someone else the power to make decisions for you if a time were to come when you couldn’t speak for yourself.
Who would you most trust to make those decisions for you? That is the person you should appoint as your healthcare representative. If for some reason that person were not available to act for you, who would be your second choice? Most forms designating a healthcare representative allow you to name an alternate.
Although no one is required to fill out a healthcare appointment, it is the most flexible sort of advance directive. Your healthcare representative can make decisions for you in a wide variety of unforeseen situations. They have a legal obligation to make decisions for you based on what you would have chosen for yourself. Therefore, naming a healthcare representative greatly extends your ability to control your healthcare decisions.
Before you name someone as your healthcare representative, ask the person if they are willing to take on that responsibility. If they are, you should have a frank, detailed conversation about your feelings and values about healthcare and the kinds of treatment you would or would not want. Be sure to give your healthcare representative copies of your healthcare directive.
A healthcare directive or living will is another way of extending control over your own healthcare. This document lets you say what kinds of care you would or would not want if you were nearing the end of your life. A healthcare directive usually refers to “life-sustaining measures.” These are advanced medical treatments that can keep a person alive past the time when death would very likely occur. Examples include CPR, dialysis, ventilation (using a machine to breathe for a person), tube or needle feeding, and antibiotics to fight an infection that could hasten death.
If you were near the end of life, would you want your life to be extended by these steps? If you fill out a healthcare directive, that document will ask you for your preference regarding specific treatments if you were at the end of your life. It is a common misperception that you should fill out a living will only if you don’t want any life-sustaining treatment at all. In fact, your living will allow you to specify precisely what treatments you would like and which ones you would refuse. Most healthcare directives also have a space to write down any preferences not covered in the specific treatment questions asked.
If you do fill out a healthcare directive, give a signed and witnessed copy to your primary physician, your healthcare representative, your hospital, and any other major healthcare institution you use. It is also wise to share the contents of your living will with your family and close friends. Let them know what you would want. Doctors and hospitals may become uncomfortable when the family is surprised by a family member’s wishes as stated in a living will, especially if family members disagree with the patient’s wishes. You can make it easier for everyone by talking openly with your loved ones about what you would want.
Visit the National Healthcare Decisions Day website (www.nhdd.org) to find more information about healthcare planning, and to access free advance directive forms for your state.