It’s the middle of a crazy busy day. As you get into your car late for your next appointment your phone suddenly rings. On the other end is someone telling you that your 85-year-old father has collapsed and is on the way to the hospital.
“Your father has had a heart attack,” you are told.
When you arrive at the hospital the emergency room doctor explains what has happened and the course of treatment they recommend. Since your father can’t speak for himself, the doctor asks you to make a series of decisions about his care.
How do you respond?
You have no idea how long he’s been unconscious or what damage may have been done. In the moment you are likely to follow the doctor’s recommendation and give her permission to take all necessary steps to save your father’s life.
But is that what he would have wanted?
You want to do the right thing, but what is the right thing?
We’re all mortal. In his book, Being Mortal, Atul Gawande states that people die in one of two ways.
Some die quickly. You get hit by the proverbial bus, suffer a massive heart attack, fall victim to an accident or otherwise meet your fate in a short period of time. For centuries, this is how most people have died. There are few end-of-life, health care decisions to make.
Others die over time. Modern medicine has not only extended our lives but also our deaths. More and more of us will not die suddenly, but will die over a period of time. During that time many decisions will be made regarding what types of care we receive, when we receive it and even if we receive care at all.
Tough decisions. The biggest decision of all may be who gets to decide. And what if that person makes decisions that don’t line up with our wishes? If your parents require care, how do you know if the decisions being made are what your parent would want? How can you be sure that you and your siblings are all on the same page regarding Mom or Dad’s care? What about your adult children? Do they know your wishes? Are they on the same page?
Be hospital ready. A well-written healthcare directive can help answer these questions.
Anne Elizabeth Denny, the Twin Cities based author of My Voice, My Choice: A practical guide to writing a meaningful healthcare directive, coaches families on how to write a healthcare directive that helps communicate your end-of-life health care choices to your family. On her website you can download a free checklist of topics to consider as you put together your healthcare directive.
A healthcare directive is a legal document, but it doesn’t have to be drafted by an attorney. In it you will need to appoint an agent to act on your behalf in medical emergencies, specify written instructions describing the type of care you would like to receive, include a HIPAA authorization (here’s why), and get your directive notarized or signed by two witnesses.
Experts like Denny can help families sort through the types of care one might receive and help you determine those that meet your wishes. They can also facilitate family meetings to help you make these decisions in advance of an emergency, and to ensure that your loved ones are on the same page and are aware of your wishes regarding your care.
The Minnesota Department of Health website also outlines the primary details that should be included in your directive. There you will find a great Q&A that will quickly bring you up to speed on why you should create a healthcare directive and what you need to know to write your own.
Crucial next steps. You’ve written your healthcare directive. You have all the right language, it’s been notarized, and you have appointed an agent to represent you. Great, but it’s all for nothing if you omit these two key steps.
First, notify your family, and in particular your healthcare agent, of your wishes. According to Denny, one of the biggest mistakes families make when creating their healthcare directive is this: They never tell anyone!
Notify your appointed healthcare agent that you have written a healthcare directive, you’ve named them as your agent, and be sure they have a copy on hand.
Second, instruct your agent to save this document in a location where they have access to it at all times — such as a PDF saved on your smartphone or online through a service like Dropbox or Google Docs. When an emergency happens, you don’t want your agent to waste precious time rifling through stacks papers to find your missing healthcare directive.
Ideally you would have had a long and deep conversation with your agent as well as your family long before you even write your healthcare directive. It’s not uncommon for families to disagree on the proper course of treatment or the care that you would want to receive. The emergency room is not the place to haggle over your care.
By discussing your wishes with your family in advance, defining the types of care you would want to receive and under what circumstances, appointing a specific person to make healthcare decisions for you if you are unable to do so, and saving your healthcare directive in a way that is retrievable from anywhere at any time, you will save your loved ones from the stress of having to make these life and death decisions on their own, and you will ensure that your healthcare wishes are met.