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While contemplating our own death is one of life’s most difficult challenges, it’s vital to think carefully about the medical treatment we would choose and to prepare family members for such an event. Medical technology can now keep us alive long after we have ceased to enjoy a meaningful quality of life.
A series of legal rulings around thirty years ago established the rights of patients to decide when life support should be stopped. The fear of being kept alive indefinitely by artificial means led many to create legal documents known as advance directives. An advance directive is a combination of legal documents like a living will describing medical treatments we would prefer and a health care power of attorney designating a trusted person to make medical decisions or relay our wishes to medical professionals and family.
Directions are included for whether we want medical providers to keep us alive at all costs, or let us pass naturally when life recovery is unlikely.
Do Advance Directives Really Ensure that We Receive the Treatment We Would Like?
Yes, because it’s just as important now to create a legal document by which to appoint a person to help communicate our wishes. However, it’s critical to establish a close relationship with one or two people – your appointed agents or proxies – who step in when you can no longer make medical decisions for yourself. The agents must know where you stand on end-of-life questions.
Consider the following when creating your advance directives so they work when you need them:
➢ You won’t be able to micro-manage every health care situation in advance. Many variables will affect your medical circumstances. Treatment decisions may depend on a team of specialists who collaborate on treatment recommendations and a diagnosis. It can be difficult, if not impossible, to interpret a legal document that was intended to guide detailed medical treatment for unknown conditions. This is why your health care agent needs to be well-informed of your preferences and reasoning behind them. Be sure they are included on your HIPAA forms required by your doctor to share your medical history and diagnosis.
➢ Creating an advance directive we online or templated forms is too basic to be helpful in most situations. Without additional detail, these documents don’t adequately address the nuances that arise or your specific state laws that may prevent medical professionals from complying with your wishes.
➢ Change is constant and humans are adaptable. It’s one thing to imagine, when in good health, that life would not be worth living if you became permanently bedridden. But when you’re actually in that situation, new meaning in life could emerge. Choices made years in the past might look a lot different in the moment of truth. Update your advance directives every year or so to be sure of your decisions. Choose time frames in your advance directives before final decisions about your health should be made.
➢ The prognosis can change with time. During the COVID-19 pandemic, if a senior contracted the illness and their advance directive stated they did not want to be placed on a ventilator, doctors assumed that the virus was fatal to seniors. Some never got the care that could have saved their lives.
➢ The documents must be readily available, both at homes and to your agents. They must not available when needed.
Getting Started with Advance Directives
An elder law attorney can help you create an effective, current, and available legal document backed up by serious conversations between you and your chosen agent or proxy. A document that meets legal requirements is essential, but having the conversation in advance is a crucial element.
That conversation should discuss your quality of life issues and what matters most. Avoid excessive detail for hypothetical situations that may never arise. Instead, provide your agents or proxies with enough information to respond flexibly to unforeseen circumstances.
When the time comes and you are unable to speak or make decisions, the agent will be equipped to convey your wishes to medical providers. The agent can focus on ensuring that medical providers furnish as much information as possible to make the hard decisions on the facts as they presently exist.
Everyone should also carry a wallet card to inform health care providers of emergency contacts. You can print a card provide by the American Hospital Association.
There are no assurances in this life, except that it will end. The hope is that we will have people to step in when we need them – and that we will have talked with them about the kind of care we want to prepare for a peaceful passing.