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April 16 is National Health Care Decisions Day.
Information about the Massachusetts Health Care Proxy, including a downloadable form, can be obtained from the Massachusetts Medical Society. For more information or to receive a packet please call 978-774-7566.
Taking Charge of Your Health Care Wishes
By Dr. Stephanie Patel, Medical Director, Hospice of the North Shore
What would be your wishes for health care if you were no longer able to speak for yourself? Most people avoid the subject as long as they can. As Medical Director of Hospice of the North Shore I’ve seen the stress families experience when they haven’t talked with loved ones about their healthcare wishes. The absence of a clear directive can cause family members to disagree on the course of action to take and may actually overshadow or delay treatment to the patient while everyone involved tries to sort out who has the right to direct the patient’s care.
Planning ahead for your health care needs is actually a gift you give yourself and your loved ones. As a physician I’ve seen many people breathe a sigh of relief when the topic is broached. They are glad for the opportunity to get the discussion out in the open and to take control of their future.
The best way to establish this control is to complete an advance directive. This document states either your wishes for care if you are terminally ill (a living will) or appoints someone you know to speak on your behalf and make decisions about your care (a health care proxy). Each state has its own version of the legally accepted advance directive. In Massachusetts, the recognized advance directive is the health care proxy, a simple legal form that doesn’t require a lawyer or any legal representation. All you need to make it binding is two adults to witness your signature. Unlike a living will, a health care proxy isn’t limited to situations involving terminal illnesses. It works for any situation where you can’t speak for yourself, from an allergic reaction to a car accident.
How the Proxy Works
With a health care proxy you assign someone to direct your care. By designating someone to be your proxy, you’re able to share your values and general ideas about how you want to be cared for. Your proxy (or agent as they are called) can then apply your wishes to whatever situations arise. In some cases that may involve engaging extraordinary means and in other cases, it might involve declining treatment. Second, the health care proxy can be easily adapted as your wishes evolve over time.
Your proxy has full authority to act on your behalf. They are not financially responsible for your care or your wishes. For your proxy, you should select someone with whom you feel comfortable having conversations about your personal choices including such tough topics as a terminal illness or nursing home care. Your proxy can be your spouse, child, friend or someone else you trust. The best choice is someone who knows you well, understands your values and beliefs, and someone who will be able, if necessary, to make difficult decisions on your behalf.
Broaching the subject: Broaching the subject of a health care proxy can be as simple as mentioning this article: “Did you see that article in the paper? What did you think?” You can also use a recent news story or television program as the impetus for discussion. And many people tackle this subject after a friend or acquaintance has encountered a health care crisis. A great time to discuss it with your family as well as your physician is at your annual physical.
Having that all-important conversation: By assigning someone to be your proxy, it leads naturally to a discussion about your wishes. Consider different scenarios that may occur. Think about situations that friends and others have faced recently. What would you want in those circumstances? What are your wishes, values and beliefs?
Where to keep your proxy: Make several copies of your proxy forms. One should go to your assigned proxy as well as your alternate proxy. Give one to your physician and keep a copy for yourself in an easy to find and accessible spot, such as a desk where you store other important papers. Avoid storing it in a safe deposit box that may need court intervention to access. In addition, you may want to give copies to other family members to ensure that everyone knows your wishes.