A few months ago, we had an older male client whose condition was worsening. Our client did not want any extraordinary measures taken to save his life. We asked him if he had an Advanced Health Care Directive. He wasn’t sure, so we contacted the family and passed along his wishes. We asked if they knew if their father had previously created an AHCD. His daughter said he had and she had all the paperwork in her possession. We were relieved and asked that she supply a copy to us as our caregiver might be the person accompanying her father to a hospital or other facility. If there hadn’t been an AHCD, and her father had become incapable of voicing his wishes, his family could have chosen a course other than the course he wanted. We’ve seen it happen time and again.
If you don’t already have one, an AHCD is essential. The directive allows you to appoint someone (a health care agent, attorney-in-fact, proxy, or surrogate) to decide for you if you cannot speak for yourself. By having an Advanced Health Care Directive, you remain in charge of your health decisions as long as you can. Once you can no longer voice your needs, the person you have appointed as your proxy (agent) will then continue to follow the instructions you have set forth.
What Does an Advanced Health Care Directive Include?
No one wants someone else making healthcare decisions for them, even if they are family members. You can make certain your loved ones know what you want by creating an Advanced Health Care Directive.
Instructions for your care (e.g., stay at home, go to hospice care, etc.)
- Acceptance or refusal of specific medical treatments (e.g., feeding tubes, CPR, ventilators, antibiotics, etc.)
- Instructions for organ donations
- Instructions if an autopsy is to be allowed
- Guidelines for your interment (i.e., funeral services, memorials)
- What powers you want to give your agent (limited or broad) over your health care
- Your primary care physician or other care providers
- If and when you want life-sustaining treatment withheld or withdrawn
- The level of care you want (Comfort Measures Only, Limited Additional Interventions or
Many seniors fear the idea of an AHCD because they believe they are handing over their lives to someone else when in actuality they are making sure that when they can no longer tell their healthcare providers what they want, someone they trust can do it for them. The AHCD does not go into effect until you are deemed incapable of expressing your healthcare wishes. You can change the AHCD whenever you’d like to, change your wishes, or name a new agent.
Who Qualifies as an Agent?
To protect vulnerable seniors, the law does have some restrictions on who you can name as your agent for the AHCD. The following individuals may not serve as your agent or alternate agent:
- A supervising health care provider
- The operator of a community or residential care facility in which you are receiving services
- An employee in a residential community or health care facility in which you are receiving care unless they are a relative, spouse or co-worker
Whoever you name on the AHCD cannot make any financial or legal decisions for you unless you have specified so in a separate Durable Power of Attorney for finances or legal issues. The agent is also not responsible for any medical bills you incur unless, of course, you have appointed them as your Durable Power of Attorney for finance.
It is a good idea to name an alternative health care agent if the individual you originally appointed as your primary agent becomes unable or unwilling to make these decisions for you. Although the form does not require an attorney, you must sign it and have two individuals witness your signature or have the document notarized. One of the two witnesses cannot be related to you or named as a beneficiary in your estate. If you are in a skilled nursing facility, one of those witnessing the document must be a patient advocate or state-designated ombudsman.
Where to Find AHCD Forms
AHCD forms are available from numerous sources including hospital, physicians, senior services agencies or attorneys, or by visiting, www.compassionindying.org. To find out more about the State of California’s rules about Advanced Health Care Directives, go to www.finalchoices.calhealth.org (California’s Health Care Decisions Law Fact Sheet) and www.cmanet.org (Introduction to Advance Health Care Directives).
What Should You Do with the Completed AHCD Form?
- Keep one copy at home in a place you and your family/agents know where it is. Provide a copy to your loved ones and Luxe Homecare for our files. Make sure your physician and attorney have copies.
- If you visit a hospital or other healthcare facility, make sure they have a copy on file.
- If you live in more than one state for extended periods of time, it may be a good idea to complete an AHCD for the other state you reside in as well.
- Carry a card or note stating that you have an AHCD. On that piece of paper or on your cell phone note the contact number for your agent and alternate agent.
Luxe HomeCare takes a holistic approach to your care, whether that’s providing caregiver or home health care providers or educating you about your legal rights. You can contact our Home Care Department at (310) 459-3535 or email us at firstname.lastname@example.org. We also invite you to visit our website, www.luxehomecare.com.