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Be Prepared for the Future

on June 19, 2012

Some people work better under the stress of a deadline. They tell themselves that they are only motivated to do their best under pressure. That may be true, but it is risky to apply that situation when seniors (and their children) have to make health care decisions in a crisis mode.

It is natural to feel uncomfortable to confront the inevitability of failing health or death with family members. Perhaps you are the daughter or son who feels it may be disrespectful to bring up the topic to Mom and Dad. Or you may be a parent and want to spare your kids from envisioning the time when you will not be strong enough to make decisions on your own.

Don’t wait for the perfect time, because there is no perfect time. Things can change suddenly, and if you don’t know your family  members’ wishes, location of documents and other vital information, it will be much more difficult to manage in a crisis situation. Discussing far-off, hypothetical scenarios are actually easier to address rather than when reality hits and you try to sort out options in the emergency room.

A good first step is to find out if there is a current will, a durable power of attorney, a health care power of attorney and an advance health care directive
(also known as a living will) in place. If not, now is the time to consult a lawyer about the purpose of each document and to understand your loved one’s options.

Exploring these legal issues will bring up many of the decisions that will need to be made. For example, your family member will need to give someone the authority to make financial and legal decisions on their behalf when completing a durable power of attorney. A health care power of attorney will require naming someone who will be responsible for medical decisions in the event of  physical or mental incapacity. An advance health care directive will provide instructions specifying what actions should be taken in the event they are no longer able to make decisions due to illness or incapacity.

Be careful about finding free forms on the Internet. While the forms may look similar to those drawn by an attorney, you can’t be sure that the “do it yourself” document will be accepted by all financial institutions and insurance companies. Additionally, different states require different criteria. Do it once, and do it correctly.

Does your family member desire aggressive medical interventions using the latest technology to battle an incurable health condition, or would they rather forego life-sustaining measures that would serve only to prolong dying? There is a document called POLST that is printed on brightly colored pink paper so it cannot be easily overlooked. POLST stands for Physician Orders for Life-Sustaining Treatment which is designed to give people more control over end of life care. The individual can detail their wishes about the degree of medical intervention they desire. It is signed by the individual and their doctor and represents a promise by all health care professionals to honor the wishes stated in the document. The POLST should accompany the documents listed above. It is not a replacement for an advance health care directive.

There are also personal preferences beyond financial and health care issues that are important to talk about. How does your family member feel about alternative living arrangements if he or she can no longer safely stay at home? If a crisis arises, who should be contacted? Do you have the names and phone numbers of their doctors, lawyer, relatives, clergy, or even friends?

These are weighty issues, and are not likely to be settled in just one conversation. It is a good idea to talk about it in person, rather than on the phone, emails or letters. Be patient and open to their responses, without bringing a hidden agenda according to what you believe is best. You may be surprised about your family member’s wishes.


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