When you choose someone to be your Power Of Attorney for Health Care (your agent), you are asking that person to make medical decisions for you if you become unable to speak for yourself. Therefore, you need to tell that person about your preferences, values, and beliefs about medical care and how these preferences might affect you. The following topics are suggested to stimulate that dialogue. Over time, your beliefs or attitudes may change, so we recommend that you speak to your health care agent on an ongoing basis particularly when your health changes. How well your agent carries out his or her role as your substitute decision-maker depends upon how well the two of you have prepared.
Describe your current health: In reviewing your medical problems, do they affect your day to day functioning? How?
Think about the importance of your independence and self-sufficiency: If your physical and/or mental abilities decline and you need help from others to function day-to-day, how would you respond?
Consider your religious beliefs: What is your religious background? Do your religious beliefs affect your attitudes toward your care? How?
Know about these life-sustaining treatments: When might you want these treatments? Might you not want these treatments? When and why?
- Kidney dialysis, used to clean your blood if your kidneys stop working.
- Cardiopulmonary resuscitation (“CPR”), used if your heart stops beating, to get it beating again.
- Artificial respiration, involving the use of a machine called a ventilator, used if you are unable to breathe on your own.
- Artificial nutrition, involving the use of a naso-gastric, gastric tube (“P.E.G.” tube), or a central line (“T.P.N.”), to provide nutrition to your body if you are unable to eat food by mouth.
- Artificial hydration, in which fluid is given through an “IV,” used if you are unable to drink fluids by mouth.
- Major surgery.
- Blood transfusion.
- Antibiotics (to treat infections).
Might you want any, some, or all of these life-sustaining treatments used: What if you were facing an end stage chronic illness, advanced dementia or Alzheimer’s disease, a persistent vegetative state, a coma, or a terminal illness? If treatment were started, might you want it stopped if it appeared unlikely to improve your health? Under what circumstances do you think you would want to be hospitalized? Not hospitalized?
Managing pain: Do you wish to have your doctor give you enough medicine to relieve pain even if that means that you would be drowsy or sleep more than you would otherwise?
Making final decisions: Do you think your doctor should make any final decisions, or should your health care agent? How should other members of your family, your friends, or clergy be involved?
“Code” or “No Code”: What do you want done if you stop breathing and have no heartbeat? “Full Code” means that emergency medical personal will attempt to resuscitate you even if you are not breathing and have no heartbeat. “No Code” means that if you are not breathing and have no heartbeat, 911 will not be called and no resuscitation will be attempted. You need to discuss this with your doctor as well as your health care agent.
Dying process: If you are seriously ill and dying, what would comfort you: being in your own home, pain management, particular family members present? What else do you want your health care agent to know?
Organ donation: Would you want to donate parts of your body to someone else at the time of your death?
Funeral: Do you have any thoughts about what type of funeral you want? What do you think about cremation versus burial? Would you want flowers, a particular song, poem or prayer said at the service? Would you want the notice to include a suggested charity for donations in your name? Are there individuals whom you would particularly like to speak at a funeral or memorial service?
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