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We make a list before going to the grocery store. The grocery list becomes our critical document before heading to the store.

We make a list before packing and going on a vacation.  The packing list becomes our critical document before embarking on the journey.

We follow a recipe when we want the dish to turn out perfectly.  The recipe becomes our critical document to ensure quality and consistency in the dish we are preparing.  This critical document becomes ever more critical if the originator is no longer with us and his/her words on an index card become our only road map.

Now let’s shift the focus of the critical document to you and your healthcare and finances.  The following critical documents become vital to you and your loved ones if the unforeseen happens.

In Case of Emergency (ICE)

This document lets others – paramedics, Emergency Medical Technicians (EMT), family, friends, and neighbors know what to do for you in the case of an emergency.  Information like your primary care physician, choice of hospital, medical conditions, allergies, religious affiliation, and your emergency contact’s name and number are found on this document.  Often, an ICE is kept in plain sight like on the refrigerator or affixed to the inside of the front door for others to readily access.

Do Not Resuscitate (DNR)

This document tends to intimidate people.  Rest assured, the DNR document is not entered into alone – it must be signed by you or your Healthcare Durable Power of Attorney AND a physician.  There are two types of DNR documents – the Prehospital DNR, which is typically created in a long-term care setting and the Hospital DNR, a document that is created while in the hospital setting and kept in the person’s medical record.  The DNR is meant to instruct emergency medical services providers of “a patient’s decision to forgo resuscitative measures in the event of cardiopulmonary arrest”.  This form does not deprive someone of other life sustaining treatments such as the need for artificial nutrition, hydration and/or pain management.

Durable Power of Attorney (DPOA or POA)

There are two types of DPOAs – one for matters involving medical decisions and the other for financial matters.  The durable power of attorney documents go into effect only when a person is unable, for physical or mental reasons, to speak and act for themselves.  An example of when a person may not be physically able to speak for themselves would be if they were placed on a ventilator and couldn’t speak their medical or financial wishes.  Mental capacity may be altered due to dementia, medications, or an injury to the brain thus activating the durable power of attorney for medical and financial.  Each power of attorney document can be as comprehensive – or not – as the originator wishes it to be.  A person’s healthcare/ medical POA does not have to be the same individual named as the person’s financial POA.  Without power of attorney documentation, a person’s financial and medical decisions will be left to a conservator or guardian, appointed by the court system.

Advance Care Directives

Advance Care Directives (ACDs) are just that – documents or directives outlining your personal medical and healthcare wishes in the case you are unable to communicate them.  We have already discussed a few (ACDs) – the DNR, ICE, and POA documents – and these documents speak for you while you are still living. Other ACDs include a Living Will, Organ and Tissue Donation, and the Physician Order for Life Sustaining Treatment (POLST) which will be discussed here.

Physician Orders for Life Sustaining Treatment (POLST)

This is a form filled out and signed by you and a physician (or Physician Assistant or Nurse Practitioner) and is often kept in your medical record at the healthcare organization where you receive care. The POLST very clearly states that it “complements an Advance Directive and is not intended to replace that document”; having both a POLST and an Advance Care Directive is the ideal situation medically speaking.  This document is very straight forward – you and your physician discuss any health conditions you may have and how you want medical interventions and/or artificially administered nutrition situations handled, should they occur for you.  There are only three options in each category of medical intervention and artificial nutrition; the opportunity to get more detailed about how you want your healthcare handled should certain medical situations arise must be spelled out in your Advance Care Directive.

Organ, Eye and Tissue Donation

If you’ve been to the DMV lately, you likely know about organ and tissue donation.  While getting or renewing your driver’s license, you must select if you want to donate your organs and tissues upon your death.  To find out more about this topic and if you want to be a donor but it’s not on your driver’s license, you can visit donatelifecalifornia.org and create or revise your account to accurately outline your wishes for organ, eye, and tissue donation.

Wills and Trusts

These documents can be drawn up by an attorney or, if you are the do-it-yourself type, you can find forms online.  If you go the DIY route, you may want to have your documents reviewed by an attorney to ensure they will hold up in a court of law should that be necessary.  A will outlines how your assets will be handled after your death whereas the other documents discussed so far direct medical and financial decisions while you are still alive.  Keep in mind, the Executor named in a will is NOT the same as being named Power of Attorney for someone.

We have covered a lot of ground in this article and while it may seem a large list of documents to gather and complete, one step at a time.  These documents are your direct path to communicating your wants and needs from a medical and financial standpoint in the event of an emergency or unforeseen medical issue.  Don’t leave your healthcare and financial situation to chance or someone else’s decision; get started today – have the necessary conversations with your friends, family, healthcare providers and financial people and begin the process of gathering and completing your critical documents.  You’ll be glad you did.

References

https://emsa.ca.gov/dnr_and_polst_forms/

Kie Copenhaver is a Certified Senior Advisor™ (CSA™), Gerontologist, and co-founder of Aging Well Partners. Kie has worked over 25 years in the healthcare and aging industries, advocating for patient’s rights and the ability to choose what’s best for them.  She has taught at Mesa Community College in the Health Information Technology department and currently gives talks at Oasis Lifelong Learning geared towards planning ahead and aging well.  When Kie isn’t working, you can find her doing yardwork and digging in her flower beds.  Find Kie at www.agingwellpartners.com