Creating Advance Care Directives, Choosing a Health Care Proxy

As we navigate the uncertainties of life, it’s essential to plan for the unexpected, especially when it comes to our health. Advance care directives and the selection of a healthcare proxy are vital components of this planning process.

These legal documents ensure that your medical wishes are respected and upheld when you are unable to make decisions for yourself due to illness or incapacity. Let’s explore the importance of advance care directives, the role of a healthcare proxy, and the steps to create these documents effectively.

What are Advance Care Directives?

Advance care directives, also known as advance directives, physician orders for life-sustaining treatment (POLSTs), or living wills, are legal documents. As an end-of-life doula, I recommend my clients make advance care directives for several reasons.

Autonomy and Control

Advance care directives empower you to make decisions about your own medical care. This preserves your autonomy even when you cannot speak for yourself.

Reducing Conflicts

I’ve seen too many families fight and argue without advance care directives. It’s heartbreaking. Loved ones have to guess, and often disagree, about the best course of action. This is while they’re grieving and emotionally overwhelmed.

These documents prevent disputes among loved ones about what medical interventions should be pursued. This eases emotional burdens. Doing this is an incredible gift to the people you love. Make plans for yourself and allow your family to simply mourn, that’s hard enough.

Relief from Unwanted Treatment

You specify the treatments you want or do not want, helping to avoid unnecessary or unwanted medical procedures. Knowing that your preferences will be followed provides peace of mind, both for you and your loved ones.

What is a Healthcare Proxy?

A healthcare proxy, also known as a durable power of attorney for healthcare or a medical power of attorney, is a legal designation. You appoint a trusted person to make medical decisions on your behalf if you are unable to do so. This person should be someone who knows your wishes and is willing to advocate for your preferences.

In many states, if you choose a healthcare proxy, your advance directives have no legal binding. However, they can still help outline your preferences and give your proxy some guidance when faced with serious decisions.

What are some other benefits of choosing a proxy?

Ensuring Your Voice is Heard

A healthcare proxy ensures that medical decisions align with your values and preferences, even if you don’t explicitly outline them in your advance care directives.

Quick Decision-Making

In emergencies, decisions often need to be made swiftly. Having a healthcare proxy can expedite the process.

Complex Scenarios

In nontraditional families, clear directives for your poxy help everyone avoid misunderstandings. Also, in complex medical situations where the directive may not cover all possibilities, your proxy can make nuanced decisions based on your best interests.

Steps to Create Advance Care Directives

Many states have guidelines and rules regarding advance care directives. Seek legal advice for your own personal situation. Begin with these basic tips.

Gather Information

Consider your healthcare values, preferences, and beliefs. Discuss your wishes with your healthcare provider, family members, loved ones, or close friends.

Choose a Format

Advance care directives can be in written or verbal form. Consult your state’s laws and preferences for guidance on the format.

Consult Legal Resources

To ensure your document meets legal requirements, consult an attorney or use state-specific advance directive forms, which are often available online. Click here for more information.

Complete the Document

Include your personal information, your healthcare proxy’s details, and clear, concise statements outlining your medical preferences. Be as specific as possible.

Witness and Notarize

Depending on your state, you may need witnesses or a notary public to validate the document. Follow your state’s guidelines closely.

Distribute Copies

Provide copies to your healthcare proxy, healthcare providers, and loved ones, and keep a copy for yourself. Ensure everyone knows where to find the document in case of emergencies.

I often help my clients make paper copies, placed where they can be easily found, as well as electronic documents. They should be updated regularly and emailed to all the appropriate people.

Choosing a Healthcare Proxy

As a death doula, I’ve seen healthcare proxies fail in their duties. They either can’t or won’t abide by the wishes of the person who trusted them to do so. I cannot stress enough the importance of choosing a proxy strong enough to do their job, no matter the circumstance. It’s vital.

Select a Trustworthy Person

Choose someone you trust implicitly, who understands your values, and is willing to act as your advocate. Discuss different scenarios with them and allow them time to consider whether they can or will do their duty if and when the time comes.

Discuss Your Wishes

Have a candid conversation with your chosen proxy about your healthcare preferences, the document’s contents, and your expectations. Include other people in the conversation so everyone involved understands what you want. It might be a good idea to videotape your advance care directives. This prevents people from pressuring your proxy if they choose a path with which others disagree.

These discussions are especially important if you’re making choices that go against your faith or cultural background. Give your proxy plenty of support by being honest and open. Hire a death doula to mediate conversations that might be tender or complicated.

It might be difficult to do, but you’re saving your loved ones a lot of strife and heartache by clearing the air before your end of life. It allows people to ask questions, voice their discontent, and ultimately accept the decisions you’ve made.

Document the Appointment

Complete a healthcare proxy document, which typically requires your signature and the signature of your chosen proxy.

Distribute Copies

Provide copies of the healthcare proxy document to your healthcare providers, family members, and the proxy themselves.

How to Have Discussions About Advance Directives

Sometimes, these tender talks aren’t easy. I’ve mediated conversations about advance directives when there’s been a terminal diagnosis and I’ve mediated them when people are simply planning ahead. These are two very different scenarios.

In general, this is how we plan such a discussion either way.

Choose the Right Time and Place

Select a comfortable and quiet setting where everyone can talk without distractions. Ensure there is enough time for a thorough discussion, so it doesn’t feel rushed.

I’ve found that doing this over a nice meal sets a peaceful tone. For many of us, gathering around the dinner table is the best way to have tender talks with our loved ones.

Be Open and Honest

Start the conversation by expressing your own thoughts and feelings about advance care directives. For example, you can say, “I’ve been thinking about what I would want in a medical emergency, and I’d like to share my thoughts with you.”

Educate Yourself

Before the discussion, educate yourself about advance care directives and their implications. This will help you answer any questions your loved ones may have and provide them with information to make informed decisions.

Listen to Their Concerns

Give your loved ones an opportunity to express their thoughts and concerns. This can be a heavy topic! Be patient and empathetic, as they may have their own fears and anxieties about death and dying.

Share Your Values

Explain your values and beliefs regarding medical treatment. Discuss what quality of life means to you and what you consider an acceptable level of intervention in different medical scenarios.

Highlight the Importance of the Healthcare Proxy

Emphasize the role of a healthcare proxy and why you have chosen them. Explain that this person is someone you trust to make decisions in line with your preferences. Again, review those preferences!

Respect Their Feelings

Acknowledge that this conversation can be emotional. It’s okay for your loved ones to have different opinions or concerns. Encourage an open dialogue where everyone feels heard.

Use Real-Life Examples

Share hypothetical scenarios or real-life stories that illustrate your concerns and the importance of advance care directives. This can make the conversation more relatable.

Offer Resources

Provide your loved ones with resources, such as pamphlets or websites, where they can learn more about advance care directives and the legal aspects of healthcare decision-making.

Follow Up

After the initial conversation, follow up periodically to ensure that your loved ones understand your wishes and to address any new concerns or questions that may arise.

The Importance of Psychiatric Advance Directives

Psychiatric Advance Directives (PADs) are powerful legal documents that empower individuals with mental health conditions to make decisions about their treatment and care, even when they may be unable to do so in the future. This could be due to a mental health crisis, or end-of-life circumstances.

Much like traditional advance directives for medical care, PADs offer individuals the opportunity to outline their mental health treatment preferences. This includes appointing trusted individuals to make decisions on their behalf and providing valuable guidance to healthcare providers.

Content of PADs

A standard Declaration for Mental Health Treatment covers treatment choices as well as the appointment of a proxy.  These advance instructions typically must be contained in a written document, signed and dated by you and by two competent adults, each of whom must know you personally and must certify that you were of sound mind when the document was created.

They must also declare that you were not placed under any pressure to sign it. 

Communication with Healthcare Providers

It is crucial to communicate the existence of all advance directives to your medical team. This includes palliative care physicians and hospice organizations. Illinois law requires healthcare providers to make reasonable efforts to comply with your wishes and they can only do this with the proper documentation.

Get Started Now

Creating advance care directives and choosing a healthcare proxy are proactive steps toward taking control of your medical care, even when you cannot actively participate in decision-making. These legal documents provide peace of mind for both you and your loved ones, ensuring that your healthcare preferences are respected.

By following the steps outlined in this comprehensive guide, you take charge of your healthcare journey and ensure that your values and wishes are upheld in any medical scenario.

Remember that tender talks are an ongoing process. While it may be difficult to start, discussing advance care directives with your loved ones ultimately brings you all closer together and provides peace of mind, knowing that your medical decisions will be respected and understood in times of need.

You’re not alone. Contact me at Anitya Doula Services for support whenever you’re ready to get started.