April 16 is National Healthcare Decisions Day, so we’re joining the campaign to raise the visibility and encourage advance healthcare planning.
Advance Healthcare Directives (AHDs) are written directions that appoint another individual to make healthcare decisions on your behalf. We’d all like to think that we could make our own decisions throughout the course of our lives, but the reality is that the majority of us will have at least a temporary period when we are unable to communicate our healthcare wishes. We not only should be appointing a trusted person to make decisions for us, but we should be thinking about important decisions such as whether or not we want to remain in our own homes or in nursing care or when to enlist the help of hospice care when we are clearly in failing health.
California Document Preparers includes an AHD as well as a Power of Attorney in our comprehensive Living Trust package. People have a lot of questions about healthcare planning issues, and there’s a significant amount of misunderstanding. Here are some common AHD myths:
Myth No. 1: AHDs are only for older people. FALSE. Older people are most likely to use AHDs, but every adult needs one. We’re all vulnerable to accidents or injuries that will leave us incapacitated, even if only temporarily. Adults should at least name someone to make healthcare decisions when they can’t.
Myth No. 2: AHDs are legally binding, so doctors have to follow them. FALSE. The decision of treating or not treating is based on the doctor’s assessment of your medical condition. Doctors may ignore the instructions if they consider them to be medically inappropriate or if they go against their conscience. The best strategy: Discuss your wishes with your providers, make sure your doctors are willing to support them, and then document your wishes.
Myth No. 3: An Advance Healthcare Directive means “do not treat.” False. An AHD can describe both the treatment you want and what you don’t want. Ending life-saving or life-prolonging care is only executed when there is no hope of recovery.
Myth No. 4: If I name a healthcare agent, I give up the right to make my own decisions. FALSE. As long as you have the ability to do so—deemed medically competent--you are in charge of your healthcare decisions.
Myth No. 5: I should wait until I am sure about what I want before signing an AHD. FALSE. While you may not be ready to contemplate the end of life, you should appoint a healthcare agent. Your directives can easily be updated as your wishes change.
Myth No. 6: Just talking to my doctor and family about what I want is not legally effective. FALSE. Talk with your doctor and family, combine this with documentation, and make sure all parties have a copy.
Myth No. 7: Once I give my doctor a signed copy of my directive, my task is done. FALSE. Like your other important documents—your life insurance policy and Living Trust—an AHD should be reviewed at least every ten years, with a divorce, death or, of course, with diagnosis of a serious medical condition.
Myth No. 8: If I am living at home and my AHD says I do not want to be resuscitated, EMS will not resuscitate me if I go into cardiac arrest. USUALLY FALSE. If you are terminally ill and do not want to be resuscitated, you should talk to your attorney and healthcare provider about an out-of-hospital DNR order.
Myth No. 9: You must have a Living Trust to stop treatment near the end of life. FALSE. Treatment that is no longer leading to stable or improved health can be stopped without a Living Trust, if agreed to by you, or your healthcare decision-maker and your doctors. However, the benefit of a Living Trust is that it allows you to leave instructions about the kind of healthcare you want when death is imminent.