By Dr. Allison Dawson, internal medicine physician at Sheridan Memorial Hospital’s Internal Medicine Practice.
If you could provide comfort to your loved ones in a time of pain or sadness, would you? Making decisions about your own health care and medical decisions now, you can prevent your children, spouses or friends from having to make big decisions that cause uncertainty and stress.
Allowing for peace of mind is a gift not given often in life and it is often not thought of by healthy individuals who feel “old age” is still years away. But the gift is one you can give by preventing thoughts such as, “What would they want?” or “We never talked about it.” But at any age of adulthood, you can prepare this gift by simply filling out paperwork and having a few conversations.
Every person has different values and wishes in regards to their medical treatment. No decision is right or wrong, as they are unique to each individual. There are many ways to document your preferences. The documents I believe are the most helpful are a Durable Power of Attorney for Health Care (DPOA-HC), a Living Will and Physician Orders for Life-Sustaining Treatment (POLST).
DPOA-HC
This form allows you to designate who should make medical decisions if you are not able to speak for yourself. This should be a person you are close to, and someone with whom you have discussed your wishes. If you do not designate a specific person, there is a pathway that will be legally followed. In Wyoming this pathway is as follows: a spouse (unless legally separated), an adult child, a parent, a grandparent, an older sibling then an adult grandchild. If this is not a reasonable decision maker pathway for you, a DPOA-HC is an important document.
For example, if your adult daughter is working as a climbing guide on Mt. Everest, she may not be a good option if you require medical decisions to be made in a timely manner. In this scenario, you may wish for your older sister, who happens to be a registered nurse and is knowledgeable about health care and your wishes, to make medical decisions on your behalf if you are unable.
Living will
This is one of the most commonly recognized forms of advanced directives. This is a document detailing specifics regarding medical treatments toward the end of life. One of the most common living wills you may have already heard of is known as “Five Wishes.” This format is written in plain language, and covers your personal, spiritual, medical and legal wishes.
POLST
This is a form that clarifies your wishes in regard to medical treatments, especially life-sustaining treatments, that are honored by health care professionals across settings, whether at home, in a hospital or an assisted living facility. This form includes preferences for attempts at resuscitation, medical interventions, artificial nutrition, medical conditions and patient goals. You may complete a POLST with a health care provider such as a physician, nurse practitioner or physician assistant. It is important to note, though, emergency medical services are legally required to attempt resuscitation unless they have access to your wishes. If it is your wish that EMS not attempt resuscitation, ID bracelets with your wishes can be worn to prevent medical treatment that is not aligned with your values.
While medical care toward the end of life can be stressful, there are things we can do now to make that process less painful for all involved.
I encourage you all to speak with your primary care provider about these documents and discuss them based on your individual health care needs.
Dr. Allison Dawson is a physician with the Internal Medicine team at Sheridan Memorial Hospital. She is trained in palliative care and hospice medicine. If you would like to make an appointment with Dr. Allison Dawson, call or text 307.675.2650.