It’s your life; make your decisions now
I want to share with you some helpful information I found in a booklet called “Smart Seniors” that was published by the state Office of the Attorney General. It talks about “health care advance care directives.” Such legal directives allow you to make vitally important and binding decisions now about your future health care, before you may be too ill to make the decisions or communicate them to your health care providers.
While most of us are reluctant to contemplate being in such a dire circumstance, it is far better to consider these matters when you have time and are able to give them careful thought than to leave them for others to make for you in a crisis.
The booklet, which is written for residents of New York state, advises, “the best way to ensure that your health care wishes are known and followed is to use Advance Directives. These are legal documents that will speak for you if you are unable to speak for yourself.”
One of your advance directives could be a Health Care Proxy that would “allow you to appoint someone to make decisions regarding the use of life-prolonging treatment, when you are unable to make the decisions. It is in effect only after a physician decides you are not able to make your own decisions.”
Accidents or illness can happen at any time and might leave you unable to understand the medical decisions regarding your care, or you might understand but not be able to communicate your wishes. So, the proxy would cover “any time you are unable to make your own medical decisions, not only at the end of life. Without a health care proxy, a doctor may be required to provide you with treatment you might refuse if you were able. No one — not even your spouse — can act on your behalf, unless you appoint them using a health care proxy.”
The booklet recommends you choose someone to be your health care agent whom trust and whom you are confident will advocate for your preferred treatment, making sure that your wishes are carried out. Don’t assume that a family member or close friend knows what you would want. Take the time to discuss those wishes with your health care agent. Talk about your values and beliefs. While no one can plan for every possible scenario, “The more your agent knows, the easier it will be for them to make decisions for you.”
A Living Will is another very important advance care directive. It will be “your personal statement about care you want — or don’t want — at the end of life. It is a document that contains your health care wishes and is addressed to unnamed family, friends, hospitals and other health care facilities. It takes effect when you cannot make your own decisions, or are unable to communicate your wishes, and your doctor confirms that you have an incurable, irreversible condition.”
The attorney general notes that “New York does not have a statute governing living wills, but the state’s highest court has ruled that living wills are valid as long as they provide ‘clear and convincing’ evidence of your wishes.”
Some people reach a point in their life and/or in dealing with their medical issues, where they want to draw a line to limit how far medical treatment should go in prolonging their life. If you choose to sign a Do Not Resuscitate Order (DNR), you are telling health care providers and emergency workers not to provide life-saving treatment if your heart or breathing stops. It would “take effect when signed by a doctor. In a hospital, the form is provided, signed by a doctor and kept in the patient’s chart. It can follow the patient to another hospital.
“Outside of a hospital, a “Non-hospital Order Not to Resuscitate” form produced by the NYS Department of Health is used. It can be kept with the patient in the event of an emergency. You can also include DNR instructions in your Health Care Proxy or Living Will.”
The MOLST form is another legal tool for expressing now what you want regarding your future care.
MOLST stands for “Medical Orders for Life Sustaining Treatment.” It is a form that “allows doctors to record your preferences regarding CPR, mechanical intervention and other life-sustaining treatments on one form as a physician order.
“MOLST is generally for patients with serious health conditions (advanced progressive chronic illness or terminal illness) and others who are interested in further defining their care wishes as they face the end of life. It must be completed by a health care professional and signed by a New York State licensed physician to be valid.
“This form can help centralize and summarize advance directives and end-of-life wishes. It is not intended to replace your current health care proxy form and/or living will.”
As I previously stated, you may not want to confront these questions, or your family members or friends may be reluctant to talk with you about them. However, it is what we all should do, especially as responsible seniors. It may lift burdens for you and for others in the future. And keep in mind you can always change your mind and change these documents.
As the AG’s booklet says, “When we do the planning in advance our loved ones will have the information they need during a difficult and emotional time.”
Don’t let the fact that these are legal documents put you off. If you don’t already have a personal attorney, PEF Membership Benefits offers a voluntary Legal Service Plan with the option to purchase an Elder Law Rider. The Elder Law Rider will provide the participant, or their dependent, with a “Legal Security Package.” This package includes a simple will, Health Care Proxy, Living Will and Durable Power of Attorney. The Elder Law Rider offers a 20 percent discount off the usual attorney’s fee included in the guaranteed maximum fees.
For additional information, visit pefmbp.com or call 800-342-4306 ext. 243.
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