Advance Health Care Directive
All of us over 18 years old need to complete an Advance Health Care Directive (AHCD) in case we get to a point where we can’t speak for ourselves or prefer someone else speak for us. It’s not about finances; this one is just for medical decisions.
It’s not about giving up control, either. IF you can make every medical decision for yourself until you die, you will. But if you ever need someone at your hospital bedside to make decisions, completing the form and naming an agent now will enable that to happen. An AHCD can serve one or both of these functions:
Appoint an agent to speak for you (Power of Attorney for Health Care)
Provide written instructions about your specific health care wishes
Where to Get a Form
Hospitals may have these forms as well as online organizations, such as NHPCO.org, Compassionandchoices.org, FiveWishes.org, and CoalitionCCC.org.
Completing a Form
Rest assured that forms come with instructions on how to complete them. Some towns offer a workshop on completing a form. In our town, our hospice company, among others, leads the workshop.
The best approach I’ve found for completing the form is to sit down with your parent and fill it out with them. This opens up rich conversation about values and fears, as you discuss some difficult scenarios. You may be surprised at what your parent wants and doesn’t want, too.
If possible, the health care agent your parent chooses should be local, objective, know your parent’s health care wishes well, be calm in a crisis, and comfortable speaking with authority figures who might be providing medical care.
Once the form is completed, you may want to make a short video on your phone with your parent recapping the important points. This way you have an accurate reminder of what your parent wants. You can watch it later if there are doubts or questions about what was said, or you just need to see your parent speaking their wishes, so you are fortified in acting on their behalf.
What to do with Completed Form
Once the form is completed, give a copy to your parent’s doctor, for the chart. Provide a copy to the medical records department at their hospital of choice.
It’s good to remember that your parent has the right to change their mind about medical treatment or the person they named as their health care agent at any time. They just create a new AHCD and replace the old version with the new so the new one is on file with the correct sources.
CAUTION: If you wait too long, your parent may lose the capacity to legally complete or sign the document due to mental changes such as dementia. You want to complete a form and have conversations well in advance and as health changes come up.
It took me two years to get my father to sign his AHCD. Many people are superstitious about discussing what could go wrong toward the end of life—thinking and talking about this stuff seems prohibited. Maybe Dad resisted for this reason, but who knows?
DAD NOTES: I would remind my dad to complete the form and he’d say, “Okay, just leave it there on the table.” Then, nothing. I pleaded with him to fill out the darn form and he’d say “You know my wishes.” I did. However, I also told him “Medical staff may not listen to me without a document proving to them that I’m your legal agent and therefore allowed to speak on your behalf.” Still, he didn’t complete the form.
So, one day, I just filled out the form, guessing at what he would have wanted. Then I handed the document to him when he was lounging outside, waiting for me to bring him lunch, and said, “Dad, sign this. If you don’t, I won’t bring you your sandwich!” He laughed and signed it, and I put it in the binder I kept for him, and that was that.
Source: an excerpt from the book, “Tips for Helping your Aging Parents (without losing your mind)” by Kira Reginato
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