Most Americans are very clear when asked to envision what medical treatments they want if faced with a life-limiting illness or accident, yet the statistics show that only about one-third of adults have any documents in place expressing their wishes for end-of-life medical care. No one can possibly think of every situation that might happen to them in the future, but you can stay in charge by putting your preferences in writing ahead of time so your doctor and family will know what kind of treatment you want, or do not want, in the event that you can no longer communicate.
In 1990, the Patient Self Determination Act gave all adults, 18 and older, the right to choose what type of medical care and treatment they desire. In preparation for a possible illness or accident that makes it impossible to express one’s wishes, documents can be prepared in advance declaring choices regarding medical treatment. These documents are called Advance Directives and they include Health Care Proxy, Power of Attorney, and Living Wills.
Health Care Agent/ Health Care Proxy: The first step in setting up an advance directive is to choose a health care agent. This is a person you trust who will make health care choices for you if you are not able to do so. A health care proxy, often referred to as a HCP, gives your agent the authority to make medical decisions for you. The HCP is a legally binding document in Massachusetts, but takes effect only when your physician determines that you are unable to communicate your wishes about your medical treatment.
Durable Power of Attorney: Another important document in planning is called a Durable Power of Attorney. It is highly recommended that this be drawn up by an attorney and determines who will manage your finances in the event of an incapacitating medical condition.
Living Wills/ Personal Directives: As medical conditions progress over time, it is important to set goals for maintaining quality of life. Addressing your personal thoughts and beliefs and preferences for life-sustaining treatments are often called living wills or personal directives. Every person defines quality of life differently and it is essential that family and medical professionals understand exactly what you want. Living wills are not legally binding in Massachusetts, but can be used by your health care agent as a guide to know what kind of medical treatment you want. This document can help start the important conversations needed in times of serious illness, including: What kind of life support treatment do I want? How do I want my pain managed? How do I want to be treated if I am near death? What are my burial wishes and preferences about organ donation?
Once advance directives documents are completed and have been signed and properly witnessed, the job has just begun. It is important that you have continued discussions about your wishes with your family, physicians and others important to you. Give a copy of your advance directives to your physician and ask that it be kept in your medical records. Keep the original in a safe, accessible place with your important documents. This will help ensure that your wishes will be known at any critical time and carried out. If you change your mind about the choices you have made with your advance directive they can be revoked at any time by simply making a new advance care directive.
Sharing your health care choices is a gift you can give to those you love, giving them the confidence to act knowingly on your behalf. By having previously documented your personal wishes and choices, the decision-making burden for family, physician and friends is lightened. At the same time, your autonomy and dignity are preserved by tailoring medical care based on your own preferences.
Care Dimensions has a team of compassionate professionals who can assist you or your loved ones diagnosed with a life-limiting illness. We can walk with you every step of the way and provide assistance in making your decisions regarding your advance care needs. For more information on Care Dimensions and the expansive services we offer for persons with complex medical issues, call 888-283-1722. If you would like a copy of Five Wishes, a document that leads you through documenting your medical care treatment wishes, please send an email with your contact information to info@CareDimensions.org.