Making Healthcare Decisions Before You Need To

It’s relatively easy to talk with a doctor about how you’re feeling when you have a mild cold. Similarly, there aren’t many hurdles stopping you from explaining how you would like to be treated for a sprained ankle. That all changes if you are not able to speak for yourself due to severe illness or injury. Healthcare professionals have launched a national effort to remind everyone about the importance of advance care planning.

“Advance care plans are sometimes called advance directives,” explained Karen Brown, MD, medical director, Primary Care, Northeast Medical Group. “Advance care plans are a written document to let your care team know who you want to be your healthcare representative to speak on your behalf and make medical decisions for you, if you are ever not able to speak for yourself.”

Advance directives for health care consist of two items; a living will and durable power of attorney for health care. Standard power of attorney is a legal document that empowers someone to make financial, legal and medical decisions for you. Durable power of attorney is different because it gives the same authority but adds specific language that makes it valid if you become unable to speak for yourself.

Many people name a parent, spouse or adult child to be their healthcare representative, also referred to as a healthcare proxy. You can choose any adult you trust. Your healthcare representative can make decisions about any part of your medical treatment, even about end-of-life care.

“There are different levels of authority you can give your healthcare representative,” Dr Brown said. “They can have full permission, at all times, with complete access to your medical records. Or they can have limited, emergency-only permissions, which means they are only empowered if you cannot speak for yourself.”

While all adults are encouraged to create an advance care plan, Dr. Brown said it can be critical for younger people.

“If you are 18, your doctor cannot speak with your parents about these things unless they are given permission,” she said. “Many younger adults don’t think about that, but it can make things difficult if they haven’t designated a healthcare representative.”

The conversation over advance directives also calls attention to living wills. A living will is a legal document that lets doctors know how you want to be treated if you can’t make your own decisions about emergency treatment. For example, would you want to be given artificial food and fluids, have a machine breathe for you (mechanical ventilation), or have your heart and lungs restarted if they stopped (cardiopulmonary resuscitation or CPR)?

Advance care plans and living wills can only be created before they are needed. We can help with additional information, including downloadable forms for designating a healthcare representative and creating a living will.