by Lake Lili
None of us really ever want to believe that our lives will end. We prep so that we have covered our bases for our survival and that of our loved ones. Most of us hope that we have put things right with our families and right with Our Heavenly Father before our time comes. Sometimes it is not possible to do, and sometimes we are forced to rely on the decision making of others, at a time when we most want control of those decisions.
As you age, who do you want making your decisions for you? Think about it hard. Sit down with a pad and pen and do some planning. Do you have your will put together? Who is inheriting all your preps? Do you want to live on a respirator?
Have surgery for cancer at the age of 95? Do you have one child who will let you go and another who wants you to live through every heroic measure? Time to think it through… Time to do some communicating…
Look at this as another form of prepping.
- Make an appointment with your doctor and get a baseline on your health. Make sure that your doctor knows your family history and that you follow-up on all the tests the doctor wants done. Then stop fooling yourself and accept the hand you are dealt.
- Work with your doctor to make yourself as healthy as possible and start doing the things that you know you need to be doing anyways – eat right, quit smoking, lower your alcohol consumption, and exercise regularly – and no fooling yourself into thinking that walking the dog down to the end of the block and back is exercise. It’s not. It doesn’t count.
So when you have got all of those basics under control the next conversation you need to have with your doctor is about the laws in your province or state regarding medical powers of attorney and living wills. In Newfoundland where I live you need to have an Advance Health Care Directive (AHCD) written that names your Substitute Decision Maker (SDM), and a back-up.
In it you need to address issues like blood transfusions, organ donations, surgical interventions, long-term care options and Do Not Resuscitate (DNR) orders. DNRs, however, do require a separately completed form, which you can get from your doctor. The AHCD will not apply in the event of an emergency (car accident) or if you are involuntarily committed for psychiatric care.
If your SDM declines the role at the time, then the Province will appoint your doctor as your SDM. So, all the more reason for you to have a good relationship with your doctor and for him to know what you want. In Newfoundland, Living Wills & Powers of Attorney do not apply to medical issues. Newfoundland will recognize the legality of the paperwork completed in other Provinces if you are visiting, but if you live here for longer than 6-months then you need to get the proper paperwork completed.
In Ontario, you need to have a Power of Attorney for Personal Care (POAPC) that covers your personal decisions, such as housing and healthcare. However, you will require a living will to communicate your wishes should you become sick and unable to communicate your wishes.
Most often people write a living will saying that they do not want to be kept alive by artificial means should they have no hope of recovery. Technically this makes the living will an “advance directive”. Even with an advance directive, Ontario still requires the completion of a DNR form.
When the Power of Attorney and an advance directive living will are combined it is called a Proxy Directive. All of which tells you that when it comes to healthcare and possible end of life scenarios, governments will make it as complicated as possible so as to ensure that they cannot be held liable by your heirs.
In Tennessee, the laws allow for advance directives for health care decision making. The directives can be called the “Living Will” or “Advance Care Plan” and the “Medical Power of Attorney” or “Appointment of Health Care Agent”. The forms that need to be completed are here: https://health.state.tn.us/AdvanceDirectives/
We are a transient society and laws seem to change and evolve quickly in this area, so check your paperwork and ensure that it still meets your provincial or state laws. They are all different too. So if you live in Tennessee but spend large amounts of time in Florida or Arizona, then you need to make sure the correct forms are completed for those locations too.
You may also need to check and ensure that the medical coverage you are denying in your AHCD will not invalidate your health care coverage. It may be in writing somewhere in the fine print but talk to your medical insurer and get it in writing.
Once all of that is done sit down with the family member you want to designate your substitute decision maker. If they agree make sure that they understand your reasoning and that your request will not conflict with their personal or religious beliefs. Have them sign-off on all the paperwork, so that it is understood that you have reviewed these directives with them and that they are understood.
Now it’s time to go talk to the rest of the family. Some will be offended but most will understand and be relieved that they will not be required to make end of life decisions. But now is the time to find out if someone is going to make a fuss about your directives and get it ironed out.
So you have been to the doctor, you are working to get healthy, you’ve talked to all the family, and you have all your paperwork completed. There are a couple of things you now need to do with that paperwork.
- File a copy with your lawyers so they have it with your will (and get one of those if you don’t have it. After all you have worked so hard on your preps, make sure they will go to a good home)
- Give your SDMa copy for their records.
- Make sure you talk with your family and friends so that they know who you have designated as your SDM. Also, tell them about your medical decisions – again argue it out now so that are not fighting you SDM.
- Give a copy to your doctor so that it is in your medical file.
- Contact your health insurer and give them a copy.
- If you have a file at a local hospital, walk into their admissions area and ask them to add a copy of the paperwork to your file.
- In Canada, our passports have a scan feature that can hold files. My sons contains his custody paperwork. Mine contains the custody paperwork and my AHCD. The Passport office was quite obliging about adding it onto the file when I renewed my passport.
In other words, cover all your bases so that the medical decisions you make, and the person you have chosen to ensure they are implemented, are recognized and taken into account. Do it now before you are diagnosed with something that could legally incapacitate your decision-making abilities. None of us want to end up like Casey Kasem.
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