Facing our own mortality is an arduous task, perhaps one of the most difficult challenges we will ever encounter. Nevertheless, if we desire a meaningful and peaceful passing, it is crucial that we contemplate it while we are still capable. For most of us, the ideal scenario is to die at home, surrounded by loved ones in a familiar and tranquil environment, rather than spending our final moments in a chaotic emergency room or intensive care unit.
Considering these two options, it is essential that we retain as much control as possible over the decisions that must be made well in advance of our last breaths. We should reflect thoughtfully and thoroughly on what makes life worth living, and decide where the threshold lies beyond which pain and limitations have eroded our quality of life to such an extent that we would rather not endure it.
To achieve this, there are resources available, such as an advance health care directive, to help you plan. Here is a step-by-step guide that will assist you in initiating a conversation about your final wishes and in determining which documents are required.
Assign a Healthcare Proxy to Represent You in the Event of Incapacity, if You’re 18 or Above
Determine who in your circle of family and friends is the best person to trust with making critical decisions regarding health care. It’s important that this individual have sound communication skills, stays composed under pressure, and handles conflicting situations while respecting your wishes and evaluating medical options. Take time for an open dialogue about what would happen if certain scenarios took place – it won’t be easy but resources like “The Conversation” can provide guidance during these difficult conversations.
Granting Authority for Health Care Decisions with an Advance Health Care Directive (AHCD)
After you have initiated that discussion, it will be necessary to officially designate your agent by completing an Advance Health Care Directive (AHCD) document. An AHCD grants legal authority to your agent or proxy to make healthcare decisions on your behalf when you are incapable of doing so.
Health Insurance Portability and Accountability Act (HIPAA) authorization
To enable your agent or proxy to access your otherwise private medical records, it’s recommended to use an authorization document that adheres to the federal Health Insurance Portability and Accountability Act (HIPAA). Without this authorization, your agent will not be able to obtain the necessary medical information to carry out the authority you have entrusted them with.
With the AHCD, HIPAA authorization, and your designated agent in place, you can rest assured that you have appointed and empowered an advocate to speak on your behalf in the event of an accident or loss of consciousness. It is advised that these documents be reviewed and updated every five years.
The next document is essential for end-of-life situations. It should indicate that you wish to receive comfort care to ensure you remain pain-free. However, it’s essential to create this document while you are still able to express your desires, and it’s best to complete them simultaneously with your AHCD and HIPAA authorization.
Physician Orders for Life-Sustaining Treatment (POLST)
No one wants to face the idea of declining health, but it’s important to ensure that your wishes are respected in case you ever experience a life-limiting condition. A POLST, which must be printed on bright pink paper, is designed to provide Emergency Responders and hospitals with recognition of a patient’s wishes in the event they are unresponsive. The POLST form should be filled out by both the Patient (or Representative if required) as well their Physician, determining whether Cardio Pulmonary Resuscitation (CPR) and other aggressive treatment measures will take place. Many states throughout America have this service available for those wishing to plan ahead during difficult times.
A POLST gives you the option to leave medical decisions in experienced hands. By engaging physicians, rather than your agent, concerning life-prolonging procedures, relieves your designated representative from having to make an irreversible and emotionally weighty choice on their own.
Ensure Your Documents are Shared: The Importance of Communicating Your End-of-Life Medical Wishes
Be sure that your important documents are never out of sight! Ensure they’re kept in a secure place, such as with an agent or proxy. Additionally, make it easy to find the POLST form by displaying it near the bed for quick access if needed.
