National Healthcare Decisions Day is April 16. Sponsor of The Conversation Project, The Institute for Healthcare Improvement uses this date to remind the public of the importance of having conversations and documenting our healthcare wishes for the future. Advance care planning are legal documents that state a person’s preferences for medical treatment, medical decision-making and end-of-life care. These conversations are important for people of all ages, as unexpected healthcare situations can happen at any time.
At Special Needs Law Group in Massachusetts, we call advance care planning “incapacity documents” because generally they are not meant to be used every day, and they are about you while you are living. These documents are designed to be used only in situations in which someone is not mentally capable of making a decision on their own, and they need help and support. The principal is the person who signs the document. These documents allow a supporter to step in and make the decisions, and take the actions, for the principal if the principal is incapacitated. Imagine situations such as when someone is in a coma or when someone with diminished mental capacity has a treatment plan that’s particularly difficult and beyond that person’s day-to-day ability to understand or make a decision. Incapacity documents are one part of a broader Framingham estate or special needs estate plan.
Incapacity documents commonly include the following:
- A healthcare proxy, which in some states is called a durable power of attorney for medical or healthcare decision-making,” names someone to function as a proxy for the principal, or the person who signs the document, when he or she may be unable to make healthcare decisions for themselves.
- A HIPAA Authorization, which is a release or authorization form to share or release medical information. It is not a decision-making document, but it allows one’s doctors and other healthcare providers to speak about the principal who signs the document with the authorized people and authorizes them to see medical records.
- A living will includes an individual’s wishes for end-of-life treatment. This can concern specific procedures such as dialysis, tubal feeding, or blood transfusion. If the person becomes permanently unconscious (coma), families can make treatment decisions based on wishes expressed in a living will.
- A do-not-resuscitate order (DNR) is put with a patient’s chart when the patient doesn’t want to receive cardiopulmonary resuscitation (CPR) if their heart stops or breathing ceases. A doctor needs to sign these DNR orders before they can be placed in the patient’s charts.
Most people want to express their wishes to avoid aggressive measures being taken to extend their lives, when the end result will be suffering and a delay of their passing. Others chose to avoid the financial burdens that may or may not result in any kind of change in their health or the quality of their life.
Some have these documents prepared to make it clear that they want to spend their final months, weeks or days at home with loved ones with care only to relieve pain or care, so they can be conscious and able to speak with those around them.
Advance directives are a blessing to loved ones since they do not have to make hard choices in a crisis situation. They know what their aging parent or spouses wishes.
It’s important to choose the person you want to be responsible for your care well in advance. Make sure it’s someone you trust, who knows you well and will be able to make hard decisions in a highly emotional time. They’ll also have to be able to communicate with your doctors and family members.
These documents are bound by the state laws of Massachusetts, so speak with our Wellesley estate planning attorneys who will be able to prepare these documents on your behalf, along with a will and other estate planning documents.