National Healthcare Decisions Day is April 16. On Wednesday, March 30, North Shore Elder Services will host an important Primetime event, “Making Choices When It Matters Most” presented by Mary Crowe, LICSW from Care Dimensions. This presentation will cover healthcare proxies, living wills, and other vital topics. There is no charge to attend.
A recent Forbes magazine article by Arlene Weintraub (March 2016) states that “very few persons actually have Advance Directives. A study in Maryland found that 60% of adults want their end-of-life wishes to be honored but only 30% had completed Advance Directives.”
There are two common types of Advance Directives; a) Healthcare Proxies and b) Living Wills. A Healthcare Proxy is a legal document that authorizes certain individuals to make healthcare decisions on your behalf when you are not able to do so for yourself. A Living Will, while not legally binding in Massachusetts, is an important document that describes the type of medical care you want to receive if you are unable to make decisions and can be quite useful to your healthcare proxy.
The Health Care Proxy lets you name someone to make decisions about your medical care if you can no longer speak for yourself. The Proxy goes into effect when it is determined by the doctor that you cannot communicate your health care decisions. These proxies allow you to appoint a person you trust; traditionally a family member is named as the surrogate decision maker.
Living Wills (Personal Directives) allow you to make statements about pursuing, withholding, or withdrawing treatment that is keeping you alive if you become terminally ill and are no longer capable of making decisions. “Five Wishes” is the most popular living will that is used in most states. Living Wills are not legally binding in Massachusetts but Wish 1 of the document (the Health Care Proxy) is legally recognized whereas the remaining four wishes serve more as a guideline of one’s wishes. You can find more about the document at www.fivewishes.com, or www.agingwithdignity.org). It is written in everyday language and allows people to express their wishes in areas that matter most – personal, spiritual, medical and legal. By communicating those wishes in writing, you allow your family or friends to understand exactly what you want. It should be considered a gift to your loved ones. Documents like this keep them out of the difficult position of having to guess what you want.
It is not always an easy conversation to have with loved ones. Using “Five Wishes” to start and guide a family conversation on the topic might be the best place to start. “Five Wishes” is a user-friendly document that takes you through the five basic decisions; 1) The Person I Want to Make Health Care Decisions For Myself, 2) My Wish For The Kind of Medical Treatment I Want or Don’t Want, 3) My Wish For How Comfortable I Want to Be, 4) My Wish For How I Want People to Treat Me and 5) My Wish For What I Want My Loved Ones to Know.
In addition to the Healthcare Proxy and Living Will, there are three other planning documents used in Massachusetts. The Durable Power of Attorney is a legal document in which you appoint a person you trust, called an Attorney-in-fact, to manage your money and financial matters if you become disabled or incapacitated and are unable to effectively manage your financial matters yourself. Medical Orders For Life-Sustaining Treatment (MOLST) is a medical document that communicates your decisions about a range of life-sustaining treatments to your health care providers across treatment settings. It is intended to be introduced to you by your clinician when you are seriously ill and takes effect immediately. The other planning document is the Comfort Care/Do Not Resuscitate (CC/DNR) which is a medical document that verifies you have a DNR order in effect. A CC/DNR allows emergency medical service personnel to provide comfort measures but not to attempt resuscitation if your heart or breathing stops.
There can be limitations with Advance Directives. Sometimes people change their minds and forget to inform others. Sometimes they are too vague to guide clinical decisions. Sometimes there are new medical therapies which were not available at the time the Advance Directive was given. Copies of documents should be kept in an accessible place known to others who can retrieve it in an emergency or otherwise when needed.. Copies of your HealthCare Proxy, Living Will, MOLST, and CC/DNR should be given to your agents, doctors and all care providers.
At North Shore Elder Services, we are able to offer our clients assistance in completing these planning documents with an in-home visit. If you are interested in learning more about this service, call Information Services at 978-750-4540. You can find all these documents and more by visiting our website at http://nselder.org/service-area/helpful-links/#health
It is an important topic and one most of us tend to avoid or procrastinate over. The consequences of being prepared or not prepared with Advance Directives are far-reaching. As Mary Crowe, Education Coordinator of Care Dimensions points out, “Advanced care planning enables one to maintain control over one’s healthcare wishes and having these discussions and documents in place gives greater piece of mind and sense of well-being.”
Join us at North Shore Elder Services on March 30 to learn more about preparing for our end-of-life wishes. There are two free sessions to choose from: 2:00pm – 3:00pm or 6:00pm – 7:00pm. Register online at regonline.com/ReadyForPrimetime, email email@example.com.