Living Wills and Health Proxies – Steps to Take During a Pandemic
Advance healthcare directives are excellent tools to ensure medical professionals follow your wishes and beliefs on healthcare. They allow you to prepare for situations in which you are no longer able to make your own healthcare decisions. Living wills and health proxies are two key advance healthcare directives that prepare you for such unexpected end-of-life situations.
A living will is a legal document that allows you to state your preferences for medical treatments, including treatment plans, pain management, or even life support. Physicians are obligated to follow it.
However, it's impossible to anticipate every situation in advance. That's why a living will alone won't complete your preparation. A living will comes into effect only when certain conditions are met, situations that might require someone else to make those critical decisions for you.
A health proxy allows you to name someone you trust, along with alternates, to make these choices on your behalf. You can give your agent instructions to follow and decide how much authority they have in making healthcare decisions. Hospitals and doctors must respect your agent's recommendations as if they were your own.
It's a common misconception that only the elderly or ailing should have advance healthcare directives. Everyone should have these safeguards in place, especially in light of the COVID-19 pandemic.
What Are the Critical Steps to Protect Yourself and Your Family?
1. Keep Others in Mind
Bringing up end-of-life conversations with your family is undoubtedly uncomfortable, but it doesn't mean that you should avoid it. Failure to address this concern might lead to more significant issues in the future that could seriously strain relationships.
An advance healthcare directive removes the weight of crucial decisions from you and your family. With the pandemic already raising everyone's healthcare concerns, now is an excellent time to ensure your family is prepared in the event something unfortunate happens.
2. Fill Out All Necessary Forms
Living wills and healthcare proxies are not the only advance directives you can have. There are a few other forms that deal with specific scenarios, such as:
HIPAA release form
Appoints a person as your agent, who then has access to your private health information.
DNR (Do Not Resuscitate) Order
During a heart failure, medical staff will make every effort to restore your heart to its normal rhythm. A DNR order instructs the medical staff that you don't want them to attempt to restart your heart using life-support measures. In effect, it means that you prefer natural death.
DNI (Do Not Intubate) Order
Informs the medical staff that you do not want to be on intubation equipment.
Organ and Tissue Donation
Authorizes the donation of the heart, lungs, pancreas, kidneys, corneas, liver, and skin upon death.
As we haven't yet invented successful brain transplants, a donated brain is mostly used for academic purposes and scientific research, so brain donation requires a separate form aside from the standard organ donation form.
POLST (Physician Orders for Life-Sustaining Treatment) and MOLST (Medical Orders for Life-Sustaining Treatment) Forms
A medical professional authorizes this document, which indicates your medical care preferences and other advance directives.
3. Update Legal Documents
Modification of healthcare directives is an easy process, but most people rarely review them after setting them up. Ensuring that these documents are updated is as critical as drafting them. The current pandemic scenario is unique, and as a result, most of these documents might not account for the ongoing COVID-19 situation.
Normally, when you're in the hospital with a critical case, your agent will most likely be present. However, that is not necessarily true amid COVID-19 quarantine protocols. It may be necessary to update HIPAA releases or health proxy documents so your agent is authorized to give directions over the phone or Zoom.
As coronavirus can cause severe acute respiratory syndrome (SARS), intubation is essential to preserving your life. But because DNR orders prohibit the use of life-support measures, hospitals could deny you a ventilator. Therefore, it is critical to revise your DNR to include a special clause for a COVID-19 infection. You should do the same for living wills that mention the prohibition of intubation.
Normally, well-drafted legal documents stand the test of time and rarely require modification. But given the current circumstances, estate planning documents, power of attorney, and other legal documents might also require revisions.
4. Convey Your Wishes to Your Loved Ones
Your healthcare agent can make recommendations only after your doctor decides you can't make them on your own. That's why it's imperative that you communicate your beliefs and wishes to your agent, such as:
- Preferences about the use or nonuse of artificial nutrition and hydration
- Decisions regarding life support in the event of permanent coma
- Decisions on treatment plans in the event of a terminal illness
Even though your agent is not accountable for any choices made on your behalf, it's still a massive responsibility, especially for life support decisions. Get their consent before appointing someone as your agent. You can also issue a signed copy of your healthcare preferences as instructions for your agent to follow.
Share these documents with your agent and medical providers. It's common for someone to set up directives but fail to notify their family or medical provider, which mostly results in their wishes being unfulfilled.
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