Want to know what one of the best Holiday gifts you can give your loved ones this year? It’s not what you think. It’s not an all-expense paid Viking River Cruise, although I’m totally good with that. It’s not the new flying hybrid car or the iPhone-99.
It’s a signed, ready-to-go HEALTH CARE PROXY.
What? Maybe it’s not what you’ve always wanted, but once you know what happens without the proxy, it’s at the top of your gift list.
True Story: An elderly reclusive aunt lives in another state and is hospitalized; mental and physical status: not great. She is a widow with no children but has nieces. Two of the five are very engaged and willing to take on some responsibility for her. They have NO documents giving them any authority, no Health Care Proxy, no power of attorney… zip.
How has this turned into a Holiday nightmare for these two women? They can’t get any information from the medical facility because they don’t have…guess what…the Proxy. They cannot influence any part of her care, including cardio-pulmonary resuscitation, life support, and nursing home placement. Often, we think that our “estate plan” or “will” covers what’s important. Obviously, it does, but what about BEFORE you die? What about your life?
We wouldn’t dream of letting the medical community assume total control over the health decisions of our minor children. Why would we feel differently about the seniors in our families? No one I speak with today is without some “dodge the bullet” story about a recent hospital or rehab center stay. That’s another article… but for today, the lesson is to get your “stuff” together. Why? Because it’s terribly consequential. For everyone.
For your “next of kin,” trying to have meaningful involvement and influence in a serious medical crisis will be next to impossible without your Health Care Proxy. This document gives your agent of choice (and an alternate) access to all medical information, the ability to dialogue with the care team, including physicians, and to direct the interventions based on your loved ones’ wishes.
And what might those wishes be? Most people have no idea. How do we get that information? Spoiler alert: we have a conversation. Using the Health Care Proxy document as a tool can be a big help as an icebreaker. Picture this: tell the story I’ve given you here (or use one of the many you’ve heard). “So and so never selected a proxy, and so when she wasn’t able to make her own decisions, the hospital made them for her.” Most likely, it’s not what any of us want.
What would you want if you had a serious illness?
Would you want full treatment even if that made you uncomfortable (chemotherapy, for instance)? Would you want surgery? How do you feel about living somewhere other than your own home? Who would you want to make decisions if you could not? The harsh reality here is that the lack of a choice IS a choice. A choice for a stranger to take on this role in your life. That’s what will happen.
The Health Care Proxy is not immediately activated like a power of attorney (POA). Once the POA is signed, whoever has those “powers” can transact business for you right then, and unless it is revoked, it is enacted until death, when its powers end. The Health Care Proxy is activated if a physician determines on examination that you cannot understand diagnoses, treatment options, and consequences of that treatment. Often, proxies are enacted after an unpredicted medical crisis that leaves the senior (or anyone, for that matter) in an altered mental state. This cause could be as simple as an infection or TIA, stroke, cardiac event, or trauma-related injury.
Most people don’t realize that once you suffer any event that could compromise your decision-making process, you cannot select a proxy. Should your condition not improve to the point that you were able to make this choice, you have essentially given your decision-making powers to someone not of your choosing, which may be permanent.
Would you ever give powers of attorney to a stranger? I think not.
Then why would you gamble with your health, and what could be life-altering decisions? The fallout from the scenario mentioned above is this: substandard care, changes in goals depending on which “hospitalist” is in charge, no input into care decisions, and no input into discharge plans from the hospital.
If you have ever participated in anything like this, even WITH a proxy, you know the complexity and energy required. Imagine trying to be an effective participant without proxy – it would be like chopping wood with a nail file. It’s almost impossible and outrageously frustrating. Never mind the poor aunt who is now at the mercy of whichever medical team is on duty at any given moment…
You can find more information about the Health Care Proxy and download the document at https://www.mass.gov/info-details/massachusetts-law-about-health-care-proxies-and-living-wills.
This is the best holiday gift you can give or get. The chaos that will be avoided is significant. The outcome can be far better for both the patient and the proxy. Discuss your wishes with your choice of proxy agent and the alternate. Ask if they can advocate for you, knowing what your wishes are. Get their buy-in before you sign. Make sure everyone has a copy of this document. I recommend a photo on your phone, and at every medical appointment, ensure they have your document in their file.
As we long for, pray for, and work for peace in our world, country, neighborhood, home, and hearts, bringing peace and avoiding chaos in our lives seems a worthy cause. Get your proxy done, then get your holiday on!
