Do you know that April 16th is National Healthcare Decisions Day? It’s not a national holiday but it is an important occasion where preparing your advance health care directive is the gift. Hopefully, many of you will think about your healthcare decisions and fill out advance health care directives to make your wishes known. As I say so often to my clients, it is not about you (although it is about taking care of yourself), it is really about making stressful times easier for your loved ones.
My own mother had a brain aneurism that ruptured and she was in a coma for a week. We struggled during this time to know what her wishes would have been. If we had known what her wishes were, we would have been relieved of the guilt and stress of having to make guesses for her.
Advance health care directives came about as a result of Cruzan v. Director, Missouri Department of Health in 1990. Nancy Cruzan was in a coma for 4 years and declared in a persistent vegetative state but the Missouri Department of Health asserted that the parents and husband could not remove her life support because there was no clear and convincing evidence that Nancy Cruzan would have wanted this. Eventually, the parents and husband were able to prove in court that Nancy Cruzan would have wanted the life support removed but it was 7 years after the accident. As a result of this case, Congress passed the Patient Self-Determination Act of 1990 which allows people to dictate their future care if they are incapacitated.
Despite the advantages of having an advance directive, the number of people who complete them is low. There are a number of reasons for the low participation rate. Some people equate advance directives with limiting care, with “pulling the plug.” But in fact, your health care directive can say you want every medical treatment known to science or no treatment to prolong life artificially, or anywhere on that spectrum.
Some people also think that drafting an advance directive is complicated and expensive, requiring a lawyer. But forms for every state (state laws regarding advance directives differ) are widely available. The CA directives are available at hospitals, from doctor’s offices, from senior centers and at www.cmanet.org. Estate planning lawyers, of course, can provide them.
People often think that your designated agent (decision-maker) may still face a fight in trying to follow your instructions. It’s not uncommon for doctors to disagree with a family about what should be done; it’s not uncommon for family members to disagree with one another. But, it’s worse, and a harder fight, if you don’t have the documents. Think of it as giving someone the ammunition to fight the battle.
Although preparing the documents can be emotionally difficult, you need to take it one step further by making sure that your healthcare directives are immediately available to you, to family members, and to the hospital in an emergency. You should give a copy to your doctor and let family members know where your health care directive is (one client keeps hers in the freezer). My office also provides our clients with a wallet card that will enable a hospital or emergency personnel to know the agent’s contact information in order to obtain the client’s legal directives.
Make it your goal to protect yourself and your loved ones by completing advance healthcare directives on April 16. Celebrate the day by making your healthcare decisions. Here’s wishing you a stress-free April 16th!
P.S. If you miss the day, don’t stress about it. Just make sure that you do it as soon as you can. Feeling at peace is worth it. Remember that “Courage is not the absence of fear, but rather the judgment that something else is more important than fear.” Ambrose Redmoon. Your love for your loved ones is the overriding force over fear.