Health care emergencies are almost always unexpected, and they are always very stressful. One of the documents we prepare for our clients is an Advanced Health Care Directive, which is a power of attorney that outlines your wishes and selects who will make decisions when you cannot in an emergency. Careful consideration must go into who you choose for this role. No matter what instructions you put in your health care directive, there will always be situations where discretion is required to make the right decisions. When nuanced circumstances arise, you need to have a decision- maker who can pivot with a rapidly changing reality about your health care.
This past week, two separate old friends and clients have had to put their fathers (also both clients) on Hospice care. Both men were physically and mentally robust for their entire lives. Now they are suffering from dementia in addition to their terminal illnesses, and their physical pain and mental confusion are making it difficult for family and caregivers to serve.
The family members are united in their care for these patriarchs, but there is discussion among the families about the ‘who, how, and where’ of their individual care plans. After they reached out to my office for help, it set me thinking about selecting health care decision-makers and the critical consequences that flow from that choice.
So how do you choose the right person? There are a few characteristics that prove to be helpful:
First, choose someone who can “spring into action” when they are needed. This is likely someone local who can be available in case quick decisions must be made. Second, pick someone who can digest complex information from your doctor and manage their own emotional distress over your situation to make clear decisions. Third, choose someone assertive and firm enough to be your advocate in an over-burdened health care. Lastly, select someone who knows you intimately enough to fill in the gaps the power of attorney document can’t cover – acting on your behalf in a way that would mirror what you would choose for yourself if you were able.
The person in your life who meets the above criteria may not be the closest relative or most obvious choice. I have a friend who chose her older brother rather than her adult children to serve as her primary health care decision-maker. She is close to her children and trusts them, but she wanted a decision-maker who would work with them as someone more removed from the emotion of the circumstances. As someone who has personally experienced removing life support from a parent, I can attest to needing strong people around me in making one of the most difficult choices I have ever made in my life.
Finally, make sure to review your choice of decision-makers often. As life happens and people move, relationships change, or those close to us may face health challenges of their own, your best choice may be different over time. In addition, make sure to develop a relationship with a dedicated estate planning attorney who you can call for advice and help when these situations arise. It has been a privilege for me to be available to my friends in that capacity this past week.
Our office has been serving our clients for the last 25 years when they need advice or a helping hand in the midst of an emergency or preparing for the future. If you would like help reviewing your current decision-makers, we would be honored to work with you to make your best choices for this vital role.