June 9, 2011
Q. My 80 year old mom, who is in relatively good health, just filled out an Advance Healthcare Directive at her doctor’s office and named me as her agent. Now what do I do?
A. I’m pleased to hear that your mother’s doctor is being proactive and discussing the importance of an Advance Directive with her. If your mom’s health continues to be good you may not need to do anything except keep in communication with her and stay on top of her medical needs. It may be valuable to both you and your mother if you accompany her to her doctor’s appointments in order that you can develop a deeper understanding of your mom’s medical conditions and needs.
An Advance Healthcare Directive (AHCD) is a legal document in which the creator, in this case your mom, hand selects a trusted person to make medical decisions for her and speak for her if she is incapacitated or otherwise unable to speak for herself. These decisions cover a wide variety of actions from making doctor’s appointments to making end of life decisions (i.e., “pulling the plug”).
However, just having this document is not enough and all AHCDs are not created equal. It is essential that as the decision-maker (aka “agent” in legal terms) you understand your rights under this document, as well as your mom’s rights and healthcare wishes. Most of those rights are described right in the document so you and your mom need to really read and understand it, so that you understand the importance of leaving instructions and information to carry out your wishes should something happen to you.
Because it is impossible to include instructions for every situation within the AHCD, you need to have discussions with your mom about her healthcare wishes. And, this is not a one-time discussion. Over the last few decades advances in medical technology have created an environment where people can be kept “alive” much longer. But there is a big difference between being “alive” and having a quality life.
Discuss with your mom what quality of life means to her. If she’s having difficulty describing quality of life or potential situations try going through the information in the POLST form. POLST stands for Physicians Orders for Life Sustaining Treatment and is used by doctors when patients are considered to be within 6 months of the end of their life. You can find the California POLST form at http://finalchoices.org/polst.php. Or you can take my Healthcare Quiz which you can find at http://chubblawfirm.com/downloads/CLF-The-Health-Care-Quiz.pdf. This discussion will help your mom avoid unwanted medical intervention and hospitalizations.