Proxies, living wills help families make healthcare judgments

Planning for one's future involves more than just saving money. Experts advise everyone over 18 to appoint a healthcare proxy or fill out a "living will" -- or both.

"Everyone should do it," stated Meg Bergh, director of the Albany diocesan Family Life Office. Making your wishes known long before ill health strikes, she said, means that "you're not putting all the burden on your family members during a time of grief. When you are quite ill, they're not thinking straight."

In addition, physicians are required to do all they can to save your life; without advance directives, the decision is not left up to your family, but to the physicians. Doctors could conceivably give you life-sustaining treatments (for instance, putting you on a respirator) even if you don't want that, unless you make your wishes known in advance.

Proxy

In New York State, the healthcare proxy is the preferred choice for patients. A proxy is a person -- often a family member -- who can speak for you in all healthcare decisions when you are incapacitated. The proxy isn't effective until an illness or accident occurs that leaves you unable to speak for yourself.

Patients appoint a proxy (sometimes called a healthcare agent) by filling out a form with the agent's name, address and phone number, as well as any special instructions about specific types of care. The agent must make decisions according to your wishes.

The proxy form must be signed by two witnesses; copies should be given to the agent, and to the patient's doctor, attorney and family. If a patient is about to be admitted to the hospital, a copy of the proxy should be brought along.

Wishes known

"It's a communication tool," said Kathleen Patterson, a nurse practitioner and project leader for the palliative care program at St. Peter's Hospital in Albany. "If [patients] don't have it outlined, it makes it very difficult for the team taking care of the patient. The family gets into a situation where they doubt themselves: `Would Mom want that?' It's important to identify an agent that can carry through with [the patient's] wishes."

A living will, on the other hand, is a document filled out in advance that states what kind of care you would like to have in certain instances. For example, you can document that if you are severely injured in an accident and have no brain activity (i.e. "brain death"), you do not wish to be placed on life support.

According to Ms. Patterson, a healthcare proxy is recommended over a living will because situations can vary, and it's better to have a person who can make healthcare decisions than a general document that's less flexible.

Every patient admitted to St. Peter's, she said, is asked if they have a proxy and, if not, is offered help in completing one.

Making a choice

Ms. Bergh noted that a spouse is not always the best person to serve as a proxy, since it's natural to want to save their spouse at any cost.

Sometimes, said Ms. Patterson, it's difficult for a proxy to separate what they'd want for themselves from what's best for the patient. She advised choosing someone who's able to make difficult decisions.

Ms. Bergh recommended using a document called "Five Wishes," which is valid in New York State. Five Wishes, a combination of a living will and a healthcare proxy, covers who is appointed as one's healthcare agent and specifies what kind of treatment the patient wants and doesn't want, how comfortable they want to be, how they want to be treated, and what they want their loved ones to know.

(Meg Bergh, director of the diocesan Family Life Office, will give a talk on the "Five Wishes" document Feb. 10, 7 p.m., at St. Matthew's Church in Voorheesville, sponsored by the Respect Life Committee. Call 453-6677 for information. To order a copy of "Five Wishes" or learn more about it, call 1-888-5WISHES or visit www.agingwithdignity.org.)

(02-06-03) [[In-content Ad]]