Contributor: Katie Neuendorf, MD
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What would happen if you experienced a sudden health crisis and became unable to communicate? If you haven’t filled out an advance directive to guide your family in decision-making, you may find yourself – and put your loved ones – in a troubling situation.
When these important decisions regarding medical care and comfort are left to the family members of our patients, they can only guess at what the patient – their loved one – would choose. Often the angst we see in families is due in part to worry over whether the decisions represent what the loved one would have wanted.
This is why April 16 has been designated National Healthcare Decisions Day. Now in its eighth year, the day has been set aside to encourage and support individuals to express their wishes in writing regarding their healthcare – and for providers and facilities to respect those wishes.
What is an advance directive?
Advance directives come in two forms:
- A healthcare power of attorney, which identifies the person you select to be your voice for your healthcare decisions if you cannot speak for yourself.
- A living will, which documents what kinds of medical treatments you would or would not want at the end of life.
When patients come to Cleveland Clinic for health care, we routinely ask if they have advance directives. Sadly, the majority of our patients – nearly 80 percent – tell us they do not.
Many think these forms are strictly about death and dying. But an advance directive helps in a broad range of medical situations, such as when you no longer are able to communicate or respond to others, cannot think or talk clearly, or can no longer recognize or interact with family or friends.
When a patient cannot speak for him or herself and does not have a healthcare power of attorney or has never outlined his/her own healthcare wishes, the healthcare team has to lean on a family that is often in shock.
The difficult part for the patient’s family members is that oftentimes there is no clear-cut, correct answer when they attempt to figure out what their loved one would have wanted.
Compounding the ambiguity is that each of us has our own opinions and preferences on how we want to deal with a serious illness. These preferences are neither right nor wrong. They are highly personal and deeply felt.
An advance directive is one way you can take control of your own medical decisions should you become incapacitated.
Just as important, an advance directive eases the decision-making burden for your family members. If you have been clear about your wishes with your family, then your loved ones don’t have to lie awake at night worried about what they are supposed to do for your care. You already have told them.
Walk the talk
I am pleased to be the physician champion of an initiative that Cleveland Clinic will participate in on April 16 — National Healthcare Decisions Day.
Today, we are giving all of our employees the opportunity to fill out their own healthcare power of attorney. We have stations around our main campus and in many of our family health centers staffed with people to help Cleveland Clinic caregivers fill out a healthcare power of attorney, provide witnesses to the document to legalize it and immediately scan it into their electronic medical records. The campaign will be at our regional hospitals in October.
It is our hope to increase patient awareness of advance directives by setting an example as their caregivers. I feel very strongly that we shouldn’t be telling patients how important these documents are if we haven’t taken the time to think about filling them out ourselves.
I know that I never want my family to question what I would want for my health care.
Resources from National Healthcare Decision Day