YOUR ADVANCE DIRECTIVE for HealthCare: Choosing a HealthCare Representative

Getting Started: What Matters Most to You?

The starting point for your end-of-life plan is your own values and priorities. What’s important to you?

Picture yourself in an end-of-life situation. What sort of care would you want?

Now picture a situation that leaves you unable to care for or speak for yourself. What’s most important to you in that kind of scenario? What do you not want to happen?

The representative you name in your Advance Directive for Health Care has the power to advocate for your medical wishes and make healthcare decisions for you if you are unable to do so.

However, the documents alone do not guarantee enforcement. That’s why it’s important to appoint someone who understands and supports your values as your healthcare representative or agent, and take the time to communicate your wishes to that person

as fully and clearly as possible.

It is also a good idea to bring an up-to-date advance directive for health care to your doctor to discuss your healthcare wishes and have the document scanned into your medical records.

AS YOU PICTURE A FEW GENERAL SITUATIONS, CONSIDER: YOUR PERSONAL BELIEFS AND VALUES.

How do your spiritual or religious beliefs affect your attitudes about terminal diseases,

treatment decisions, or death and dying? Would you want life-sustaining treatments no matter the circumstance, or do you believe that when there is no hope of recovery, natural death should be allowed?

» QUALITY-OF-LIFE CONCERNS. What basic abilities are important to you in order to feel you would want to continue living? For example, do you feel you must be able to recognize loved ones or communicate with others?

» TYPES OF LIFE-SUSTAINING TREATMENTS. Are there specific procedures or treatments you would want or definitely not want if you were diagnosed with a terminal condition? Seriously take into account quality of life when considering life sustaining treatments. (Refer to Slow Medicine article)

» YOUR SUPPORT NETWORK. Is there a particular doctor you want to help your family direct

your care? Is there anyone you do not want involved in your healthcare decisions?

"FACTORS" TO CONSIDER WHEN CHOOSING A REPRESENTATIVE for Your Advance Directive for Health Care

Your representative can be anyone you trust who is at least 18 years of age: your next of kin, another family member or someone else. You cannot, however, appoint your primary care physician or any other healthcare practitioner involved in your care unless they are related to you by blood, marriage or adoption. You can name an alterna-tive representative to step in if your primary representative is unavailable. Once you’ve chosen someone, avoid potential conflict by letting others know your choice.

IN SELECTING A REPRESENTATIVE, ASK YOURSELF:

» Are they assertive? You want someone who is comfortable speaking with healthcare providers and advocating for you.

» Are they comfortable talking about death? They will need to engage with the subject.

» Do they live nearby? In a crisis, having someone local can be important.

» Will they respect my decisions? They need to understand where you’re coming from and

be willing to honor your requests.

» Do you think this person will be able to emotionally handle this responsibility?

Early conversations matter. Talk about your preferences regarding the extreme measures doctors might use to prolong your life. Is your potential representative comfortable with your choices?"

IMMEDIATE FAMILY?

If you’re finding it hard to identify an appropriate person to serve as your representative, remember

that they do not have to be a family member. Many people automatically list a family member or next of kin to be their healthcare representative. This is not always the best choice. Think carefully about the person you choose: Other options include:

» A nearby friend whom you trust instead of a distant family member.

» You can consider asking a neighbor or a member of your faith community. When

discussing your request, let them know there is no financial liability attached to this role.

» Your local senior services/elder care agency may have a program that provides volunteers

for this service. If you are on hospice, discuss this with your hospice provider.

» Some communities have geriatric case managers who may serve as healthcare representatives

for a small fee. Inquire with the Aging Life Care Association for professionals in your area at Aginglifecare.org.

» Attorneys who specialize in elder law may also be willing to take on this role. Find a list of

local attorneys by contacting the National Academy of Elder Law Attorneys at https://naela.org

(information above taken from Compassion and Choices Advance Care Planning Guide: https://compassionandchoices.org/resource/eoldgt/