MAKING CHOICES BEFORE A HEALTH EMERGENCY
By Jen Jacobson
Women often take the lead when making health care decisions for their families. But what if an emergency occurs—an accident or a stroke, for example—leaving you unable to express your wishes for your own health care?
Unfortunately this is a common scenario, and one that can occur at any stage in life. That is why it is critical to prepare an advance health care directive. This documentation allows you to name a trusted person to make these decisions on your behalf. It also can allow you to document your health care preferences and goals.
“People often think of advance directives as just for nursing home residents,” says Tricia Schilling, Nursing Home Services and Social Services Manager with Olmsted Medical Center. “But every adult needs to be thinking about what would happen.”
CHOOSING AN AGENT
The person you choose to make health care decisions when you’re unable is referred to as your health care “agent,” “proxy” or “representative.” This person doesn’t have to be a spouse or family member, but does have to be at least 18 years old. Ideally, it’s someone who knows you well, is good with critical decision-making and is someone you trust to respect your wishes and speak up on your behalf. You may also choose alternate agents in case your primary agent is unreachable or otherwise unable to fulfill the role.
Once you’ve identified a good candidate, talk to that person about including him or her in your health care planning and the decisions you’ve made about any potential care. Ideally it’s a role that will never need to be fulfilled. But if need be, your agent will be ready to react.
The other component to a health care directive is a statement of your goals, values and preferences about your health care so that your health care team can act according to your wishes. You can be as specific or as general as you wish. Common topics may include where you’d like to receive care and whether or not to use life-prolonging measures such as CPR, ventilation, dialysis or placement of a feeding tube. It also may cover end-of-life decisions such as comfort (palliative) care, as well as organ and tissue donation.
COMPLETING YOUR DIRECTIVE
While an attorney can help you prepare a health care directive, it can be done on your own, as well. State-specific forms can be found through organizations such as the American Bar Association and the National Hospice and Palliative Care Organization. Mayo Clinic and Olmsted Medical Center (OMC) also have packets available.
OMC also offers an abbreviated version of the directive, which focuses on naming your agent and a brief statement of health care goals. “The full directive can be intimidating, but we’ve really seen numbers increase with using the abbreviated version,” says Schilling. “We still urge people to complete the full directive down the road, but at least we’re getting something on file.” Once complete, the document must be notarized or signed in the presence of two witnesses. At OMC locations, these forms can be notarized at no charge.
Storage of your completed directive is key. In addition to keeping a copy in a safe place, give a copy to your agent and any alternate agents and file a copy where you receive primary medical care. These forms may be changed at any time. It’s a good idea to review periodically—at least every 10 years.
Talk to the important people in your life about your advance directive and your health care wishes. By having these conversations now, you help ensure that your loved ones understand your preferences and can help lift the burden of any future conflict or guilt. Says Schilling, “It’s a gift you give to your family when you have one of these documents on file.”
Health care directive resources for Minnesota residents Minnesota Bar Association
National Hospice and Palliative Care Organization
Olmsted Medical Center
Jen Jacobson is a local writer and editor.