April 16th is a pretty important date. Besides it being my daughter’s birthday (Happy Birthday Grace!), it is National Healthcare Decisions Day!
On this day, we encourage all of you to discuss and plan for care before an illness or emergency occurs. Having a health care directive on file is important. But to further that, have you spoken to your surrogate decision maker about your wishes? If you are unable to express these wishes at the time, do they know if you have a “do not resuscitate” order? Do they know if you would wish to continue or discontinue artificial nutrition and hydration?
Considerations when creating a directive
Our healthcare system is, appropriately, set up to preserve life and restore health. If restoring health is impossible or unlikely, decisions about treatments and technologies to preserve life become crucial. When healthcare decisions must be made having real guidance from the patient, either directly or via a document, is a huge blessing to all involved. While drawing up your Health Care Directive, beware of vague statements. For instance, the statement “I want to have life-support treatment if my doctor believes it will help” – the nature of “help” is unclear.
Certainly, life-support treatment can help sustain biological life, but it might not help the patient recover or regain quality of life. Then your surrogate decision maker is left to try to determine what you meant by “help”. Having these discussions with your decision maker prior to any illness or emergency, eliminates the guessing they would have to do. Open, honest, and in-depth discussions now can head off serious conflicts or uninformed healthcare decision making down the road.
Tools to get started
Two helpful web-based tools are available to jump-start the process of defining your quality of life:
~ Caring Conversations (www.practicalbioethics.org)
~ The Conversation Project Starter kit (www.theconversationproject.org)
It isn’t too late to start
If you know someone who is already seriously ill, you may have them explore the POLST (Physician’s Order for Life-Sustaining Treatment) form. This form provides a way to quickly communicate key treatment choices during transitions. An example of this is the transition from the nursing facility to the emergency room to a hospital stay and back to a nursing facility. This is a standardized form that enables clear, quick communication of key treatment decisions. It is signed by a medical professional and accessible to professionals at the various facilities. Consider it a portable medical order. Check with the state you live in to see if your state offers this program. For example, Minnesota offers it, Florida does not.
It is impossible to predict which scenarios of illness, dying, and death will play out in our lives. It is equally difficult to anticipate all the healthcare decisions and choices that must be made to manage illness, treatment, and care. Planning offers an opportunity to give thought to bottom-line values and goals. These important goals relate to preserving independence, autonomy, and quality of life for as long as possible.
White Oaks Wealth Advisors has many resources to help you with your healthcare decisions. Please reach out to any of us with your questions as we are happy to help.
Cyndi Castle is the Vice President of Family Office Services at White Oaks. She manages the family office client service relationships and communications, and specializes in providing investment oversight service.