When Should You Review and Update Your Healthcare Directives?

It's been more than a year since the COVID-19 pandemic struck us. We learned to wear masks and carry sanitizers and make sure we eat healthy to improve our immune system. Is that enough?

When you feel healthy and positive, it's easy to feel comfortable and safe. But what happens if you suddenly experience significant health issues or even an accident? 

It's critical to prepare for potentially life-threatening health issues. This is when a healthcare directive becomes relevant. A healthcare directive is a document that allows you to inform others about your wishes and beliefs regarding your healthcare. It also lets you name a person as your agent, who can then make decisions for you if you are unable to do so.

A healthcare directive isn't mandatory for using any of the services offered by a hospital. Also, even if you cannot convey your wishes, those close to you will surely try to do so for you. Considering all this, why is it still essential to have a healthcare directive?

No matter how close someone is to you, their thought process will never perfectly align with yours. A healthcare directive will ensure that your wishes regarding your healthcare are carried out.

Why Is It Necessary to Review or Update Healthcare Directives? 

Creating a healthcare directive is just the first step in a lifelong process. The world is constantly changing — new diseases will come and new treatments will be discovered. 

Consider the case of COVID-19. Coronavirus targets your respiratory system, which could make intubation critical in preserving your life. However, if you have a do not incubate (DNI) form in your healthcare directive, it complicates the whole process. That's why it's vital to periodically review, revise, and update your healthcare directives to account for these developments. 

Regular reviews ensure that you get the best out of your healthcare directive. So, when exactly should you review or update your healthcare directive? There are some major life events that should trigger a directive review, summarized by the five D's — Decade, Divorce, Death, Diagnosis, and Decline.

1. Start of a New Decade

Most changes in your life, health, and values are so minute and gradual that you hardly notice them. But over a decade, these small changes, along with major ones, will influence your lifestyle, wishes, and beliefs. The person you are in your 20s will be very different from who you are in your 50s. 

When you prepare a healthcare directive, you make your decisions based on your beliefs and health status at that particular period in your life. As time passes, your health and views about end-of-life care might change. That's why you should update your directives periodically to ensure that they represent your current wishes and beliefs. 

The best way to do this is to review your healthcare directives when you enter a new decade of your life. In other words, update them when you turn 30, 40, 50, and so on. 

2. Divorce or Other Changes in Family Dynamics

Most people name their spouse, life partner, or adult children as their agent in a health proxy. However, relationships can change. Review and update your proxy after a divorce or other family crisis. Your agent should have your best interests in mind while making crucial healthcare decisions for you. This is not guaranteed if you are no longer emotionally attached to that person. 

A proxy you are no longer close to could make bad choices intended to harm you or knowingly go against your beliefs. To reflect present conditions, review and update your healthcare directives after any significant change in your family dynamics. 

3. Death of a Loved One

Your own health proxy is likely low on your list of things to worry about when grieving the passing of a loved one. But what if that person was your agent in a proxy or other healthcare directive? 

Some healthcare directives, like HIPAA releases and health proxies, require an agent to come into effect. In the absence of one, none of these documents are valid. If your agent passes before you, review and update your documents sooner rather than later. Even if it's painful, you must replace your departed agent with someone else.

4. Diagnosis of a Serious Medical Problem

A diagnosis of a severe medical issue, like cancer or heart disease, will significantly alter your life decisions, possibly requiring modifications to your existing directives. You can also prepare a physician order for life-sustaining treatment (POLST), which is intended for those with a terminal illness. A POLST is a doctor-ordered instruction to ensure that you receive your preferred treatments even in an emergency.

5. Decline in Health Conditions

Unfortunately, no one has invented a cure for old age. It’s a simple fact of life that you will start noticing natural declines in the quality of your health, which may result in needing assistance for your daily routines or having to move into an assisted living facility. All of these are significant changes to your lifestyle that might change your perspectives about life and healthcare. You must review your health directives to account for these changes.

How to Create and Update Your Documents

Your preparation is not complete after reviewing and updating your healthcare directives. It is equally essential to notify everyone in possession of copies of your directives about these changes.

In scenarios that require many changes, it is always advisable to make a new healthcare directive. Making changes to the existing documents might confuse readers and also increases the chances of errors. So, creating a new living will that is clear, current, and easy to follow is the best course of action. 

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