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advance directive

23.04.2006

Advance Directives for Health Care and Financial Authorization


Your Self Help Advance Directives

For the sake of everyone, It is hoped that you will never be incapacitated or hospitalized, and that a long, healthy life awaits you. But just in case you are urged to make the simple arrangements for an advanced directive and durable power of attorney for health care. Do this advance directivefor yourself and for the people you love. Do it now, while you're strong and healthy. They might be the most important documents you ever sign.

The advanced directive and durable power of attorney for health care directly affects the quality of your life and the quality of your death--the manner in which you leave this world. The right to die, which means the right not to be put on life support, is something we've only had in the United States since 1990. It is a right explicitly granted to us in decisions by the U.S. Supreme Court. Since that time, however, the courts in the different states have made it clear that unless you put your wishes in writing, a doctor does not have to cease life support for you, no matter how devastated your body is, no matter how much competency you've lost, no matter how much of a vegetable you've become from whatever it is that has befallen you.

The reason this is important to you, not only emotionally but financially, is that most health insurance policies put a cap on the maximum amount they will pay for an illness. This maximum varies from policy to policy, but the average is about $1 million. So, after your insurance company has paid out about $1 million in benefits, it's done. The rest is up to you and your loved ones. With cost of hospitalization skyrocketing, surely you can imagine that it would not take long to reach the maximum if you happened to be on a life-support system in a hospital. And yet the medical bills would keep piling up. Having an advanced health care directive and durable power of attorney for health care is part of being responsible to your family, not only on an emotional level, but on a financial level as well.

An Advance Directive For Health Care

Also known as a living will, a directive to physicians, a health-care declaration, an advanced health-care directive, or a medical directive, the advanced directive for health care is a written document that dictates what you want to have happen to you if you are incapacitated. You can choose from three basic options:

You want to prolong your life for as long as possible, without regard to your condition, your chance of recovery, or the cost of treatment.

A Durable Power of Attorney for health care (DPOA) is a stronger form of an Advance Directive than a Living Will because it enables you to appoint a health care agent or proxy to see that your health care preferences are honored. Not only is a DPOA harder to ignore than an Advance Directive with only written instructions, but also a health care agent can then make decisions on matters not covered in the written document. Your agent is someone who knows you well and has a better idea of what you would want than the hospital staff. In addition, your agent has the advantage of NOT being either in crisis or in a coercive inpatient situation, personally. This frees him/her to insist energetically that your advance wishes be respected, at a time when your own self-advocacy skills are likely impaired.

Although the legal authority for setting up a DPOA for all health care decisions was established under the federal Patient Self Determination Act of 1990, these rights must be asserted to make them both real and inclusive. This is true of all new civil rights laws, such as the Americans with Disabilities Act (ADA), also passed in 1990.

Three important elements in making a DPOA work for you:

  1. Select your agent with care. Will the agent carry out your wishes or will the agent impose on you what they would have wanted for themselves or what they think is best for you? Does your agent know the psychiatric system well enough to be useful in enforcing your wishes? Even more important, does the agent have the gritty determination sometimes needed to go to bat for your preferences even when they conflict with a doctor's idea of what you need?
  2. Be as specific as possible in your written instructions in a DPOA. Address physical as well as psychiatric incapacity. Whenever possible, write out instructions of what you do find useful in a crisis: Advance Directives are not only for refusing treatment. For the minority who find it comforting to have the system control them when they lose self-control, state very clearly what treatment you want, by whom, in what circumstances

You do not want your life to be prolonged unnaturally, unless there is some hope that both your physical and mental health might be restored. To protect themselves, hospitals will offer you a generic power of attorney. This simply protects them for your visit. It does not protect you at any other hospital, care center, etc. You need to bring your own Advance Directive documents with you.

Durable Power Of Attorney

A durable power of attorney for health care (may also be called medical power of attorney, a health care proxy, an appointment of health care agent or surrogate) is a document that designates someone who will have the authority to make health-care decisions if you cannot because of an incapacity. The person appointed may be called a health-care agent, a surrogate, an attorney in-fact, or a proxy.

In the durable power of attorney for health care, you must decide in whose hands you want to put your life--who, that is, will make the final decision to take you off life support, if the decision ever has to be made. It is best to have an agent and two alternates, in case the person you have chosen is not available. Choose people who love you yet are strong enough to do what you would want them to do. This is not an easy position to be in.

Financial Power Of Attorney

A financial power of attorney is a document that that authorizes another person to act for you as if that person were you. This person is called your "agent" or your "attorney-in-fact." You can create a very broad power of attorney, which allow your agent to do things that usually only you can do, such as write checks from your bank accounts, pay your bills, or sign documents on your behalf; alternatively, you can create a very limited power of attorney, which may authorize the agent you name to do just one particular thing for you.

The best power of attorney is one that does the following three things: is authorized by a specific state law (also known as a statutory power of attorney); is a general power of attorney; and survives the incapacity of the maker. These three factors will give you the greatest ease in getting people and institutions to cooperate with you when you transact business through a power of attorney. Your power of attorney needs to be "durable" --to remain in effect if you become incapacitated. This is the main reason for any power of attorney (advance directive).

Our Advance Directive package includes documents for both health care and financial. You are provided with step-by-step instructions on each forms as to what information is required. You need to have this information in place now! Relieve your loved ones of unnecessary burden and stress.

Download your self help Smart Advance Directive / Power of Attorney package here!

 

self help smart advance directiveIt took the Terri Schiavo case to grab my attention to the importance of an Advance Directive for Health Care. Your package also included Powers of Attorney for health and financial directives, in addition to burial directives. What a relief. Thanks.self help smart advance directive

 

Carmela,

Bronx, NY

 

 

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