Happy elderly couple relaxing on park bench near pond with ducks in spring.
You have an estate plan. You have wills, trusts, and all the rest. Excellent. Do you have a “life plan?” What do you have in place to take care of you on THIS side of the sod? Like a formula to an estate plan, there is a MUST DO checklist that needs priority attention regarding your health, care, and decision-making during the “golden years.”
I have heard that one million times. Yes, wouldn’t that be great? Unfortunately, a serious life-limiting illness is often not born from a single sentinel event. Most of the time, the causes of elder disability are the worsening of chronic medical conditions that have been present and treated for years. Independence doesn’t evaporate overnight. Cogent thinking, physical ability, and intact self-care fade over time and can be so gradual that it happens right under our noses.
Consider your own experiences. Can you think back to your grandparents or parents and remember how the changes came in waves? There may have been periods of stability that were sandwiched by big changes. We are beings that create a “new normal” during periods of even extreme change. Look what we did during COVID. Who imagined we would have found that staying physically distant from everyone we know could have become the norm?
The “ducks” in my wheelhouse are: Health Care Proxy, MOLST (Medical Orders of Life Sustaining Treatment), HIPAA Authorization, and Emergency Preparedness. These documents provide as solid a structure as possible to facilitate your choices for medical care. So, let’s tackle those one at a time.
The Health Care Proxy document allows you to designate a primary and secondary Health Care Agent who can make healthcare-related decisions for you if you cannot do so. Your agent is an individual. The notion that “all my children are my Health Care Proxies” doesn’t fly. Your medical team does not want to deal with a committee that may or may not agree on anything.
You are assigning a primary and secondary individual to speak for you. What do they need to know as they take on this role? The answer is: what you want for medical care if you cannot direct your team. Your agents prepare for this role by having an in-depth (sometimes facilitated) discussion about the options in various medical scenarios, a clear exchange of information, and a comfort level for you and your agents. You do not need an attorney to complete this document. The Health Care Proxy document is available online at: Mass.gov.
The MOLST (Medical Orders of Life Sustaining Treatment) document is an active “doctor’s order.” It pertains to lifesaving and sustaining medical treatment. Truthfully, this document and its contents can be anxiety provoking, so I often use it as an outline for a discussion. A conversation starter. This is necessary because all medical facilities and emergency medical providers operate under “doctors’ orders.”
If you do not have the MOLST document in place, emergency decisions you do not want could be made. Like the Health Care Proxy document previously discussed, this document helps ensure that you receive the interventions you have chosen and not the ones you haven’t. You can review and complete this document with your primary care physician. The MOLST document is also available online at Mass.gov.
The “Health Insurance Portability & Accountability Act” was made law in 1996. It was enacted to ensure privacy concerning all healthcare information. This means that regardless of relationship (spouse, child, sibling, parent of an adult child, etc.), we are not automatically entitled to medical information, even in serious illness or hospitalization cases.
What is needed to bypass this limitation is a HIPAA Waiver. As the patient, you waive your rights to privacy and extend information to be shared with whomever you designate. There is no limit on how many people you wish to exempt from HIPAA restrictions.
This is a document you can “DIY.” Include your name, the date, and your statement indicating your desire that the “following persons be allowed to have access to my medical information” with your signature. Notarizing the HIPAA Release/Waiver with witnesses is always a good plan.
Now more than ever, our seniors and elders are on the move. We are living longer with chronic illness and are still out and about. A small index card with your current medical conditions, allergies, medications (dosages and frequencies), primary care provider contact information, and emergency contact information is critical.
This information should be readily available at home for any Emergency Responder (usually kept on the refrigerator door). It can be in an envelope for privacy but labeled “EMERGENCY MEDICAL INFO.” Keeping this information available in the event something occurs out of the home is equally important. Most first responders will look behind the Driver’s License in the wallet for such a card. This can be lifesaving.
Ensure you have a copy if you have initiated the Health Care Proxy document with your Attorney. A document in a file drawer is useless to you in an emergency. These documents should be shared with your “team,” and participants should have copies on their mobile phones.
I haven’t worked with a family or individual who hasn’t expressed great peace of mind and a sense of security and relief after completing this checklist. You don’t know what you don’t know…until you do. So… now you know. Listen to the sneaker company NIKE. Please, just do it.
