Durable Power Of Attorney For Health-care Decisions

GENERAL INFORMATION:

What is a Durable Power of Attorney for Health-Care (DPOAH-C)? A DPOAH-C is a written record that lets you choose a healthcare proxy or agent (person). This person will make decisions about your care when you cannot. A healthcare agent is helpful when family and caregivers cannot agree about what to do. Talk with your agent, family and caregivers after you have finished your DPOAH-C. Also, make sure your agent, family, and caregivers have a copy of your DPOAH-C. Each state has a special form to fill out for your choice of healthcare agent. A DPOAH-C form usually needs to be notarized (officially stamped) by a notary public.

What kind of decisions can my agent make for me?

• Most forms say that your agent will make all healthcare decisions for you when you are unable to make them for yourself. This may include when to start, stop, or refuse any treatment, procedure, or service. Your agent will be able to talk to any of your caregivers for information on your health to help him make those decisions. He will probably be able to sign any legal papers for you when needed for any of your health decisions. When making decisions for you, your agent will base them on information you have given him in the DPOAH-C, or in another way.
  
  
• If your agent is not sure, he will make decisions based on what he thinks would be best for you. This is why it is very important to talk to your agent about health decisions. And, also what you have written in your DPOAH-C.

What are some of the things I will need to think about? The following are some decisions you will need to make when you fill out a DPOAH-C.

• Who should I choose to be my agent? You should choose someone who is able to follow your wishes exactly . This person must be at least 18 years of age. Usually this person can be a family member, or a friend. Keep in mind that this is the only person who will be able to make decisions about healthcare for you. You may also be able to choose a second, or even third person to be a replacement agent. This replacement person would fill in for your agent if he or she cannot be present. Or, if he or she is unable to make the decisions for you.
  
  
• What kind of care do I want to receive? The form should have a place for you to tell caregivers what kind of care you do, and do not want. It is important to write both of these down. Put medical procedures you may need, or that you have liked, or disliked. Put your wishes about any special medical conditions like coma, or terminal illness, and organ or tissue donation. You may be able to write your beliefs about how long you want to live (quantity of life) and how you want to live (quality of life). This may include your views on health, being independent, and in control.
  
  
• Are there any special limits I want to put on the care I choose? The form you fill out may also have a place for you to tell caregivers about any limits on health decisions. This may include time frames to any care that you have said you do, or do not want. For example, you may choose to have all treatments and care while you are in a long-term coma. But, you may also write here that, "if I am still in a coma after 6 months, I want all care including food and fluids to stop." You may be able to include your wishes about organ and tissue donation here. And, you may write your beliefs about how long you want to live (quantity of life), and how you want to live (quality of life). You may also include your views on health, being independent and in control.

What do I need to think about when I am writing my DPOAH-C? Your DPOAH-C describes your "values and beliefs" history. Your written form needs to describe more than just legal information. It also needs to have what you feel and think as a human being about life. The more information and feelings you put into your advance directives "history", the better people will understand exactly what you want. The following steps explain what to do when writing your DPOAH-C and deciding on your healthcare agent.

• Ask caregivers questions about anything you do not understand. Make sure you fully understand treatments or care you may receive before you write down your wishes.
  
  
• Check your state laws to make sure that what you want in your DPOAH-C is legal.
  
  
• Plan your DPOAH-C when you are not upset , or having an emergency medical problem.
  
  
• The kind of care you do want is as important as what you do not want. Look at the benefits and burdens (problems) that each of your decisions may cause for you and your family.
  
  
• The following may help you to write down your thoughts and beliefs about certain medical situations. Your ideas about each of these may help your family, agent, and caregivers to better understand your wishes.
  
  
  • Medical procedures you may need or that you have liked or disliked.
    
    
  • What you think about organ and tissue donation.
    
    
  • Your views on health, being independent, and in control.
    
    
  • Your beliefs about religion, God, and heaven.
    
    
  • Your beliefs about quality of life (how you want to live) and quantity of life (how long you want to live).
  
  
• Think about the following 4 situations when you make decisions about what you want medically.
  
  
  • What if I am in a coma and I have no possible chance of waking up from it?
    
    
  • What if I am in a coma where I might wake up and be OK?
    
    
  • What if I have brain damage?
    
    
  • What if I have brain damage and a terminal illness (sickness that causes death)?
  
  
• Then think about the treatments below that might be offered in each of these situations above.
  
  
  • Antibiotics.
    
    
  • Blood transfusions (trans-few-shun).
    
    
  • Chemotherapy (cancer fighting medicine).
    
    
  • CPR. (re-starting your heart and breathing when it stops)
    
    
  • Invasive (in-vah-siv) tests (tests that are uncomfortable or cause pain).
    
    
  • Surgery.
    
    
  • Tubes or IV's to give you food or fluids.
    
    
  • Ventilator (machine that breathes for you).
  
  
• This is where you choose what you want for care. Pick 1 of the following choices for the above possible treatments for short-term or long-term brain damage or coma.
  
  
  • I would want it.
    
    
  • I want the treatment tried; but if I do not clearly get better, then stop it.
    
    
  • I do not know if I want it.
    
    
  • I do not want it.
  
  
• When you have finished you DPOAH-C talk to your family, health-care agent and caregivers about it. This will help everyone to understand your wishes. Give each person a copy of your DPOAH-C. Keep one for yourself in an easy to get to place at home. Keep a card in your wallet, billfold, or purse that says you have advance directives. The card should also say where your DPOAH-C can be found and who your agent is.
  
  
• Make sure caregivers understand that you need extra help if you have hearing, seeing, or language problems. A translator that speaks your language can be present when caregivers talk to you about DPOAH-C. If you have seeing problems caregivers can get forms that are in large print. Or if you have hearing problems they may get someone who knows sign language.
  
  
• Review your DPOAH-C when your life and health situation changes. This includes when you travel or move to another state. Remember you can always change or cancel your directives. But, if you make changes always give new copies to your family, health-care agent, and caregivers.

Do I need someone to watch me sign my DPOAH-C? Your state law may require you to have people watch you sign the DPOAH-C. Then they will also sign to say that they were witnesses. Some states may want you to have a special kind of witness called a notary public. A notary public has a special place in state law as an "official" witness. He will use a special stamp on the form to show that he or she saw you sign it. It is very important that you follow your state's rules about witnesses exactly on your DPOAH-C. If you do not, the DPOAH-C may not give your agent the rights he needs to follow your wishes and make decisions for you.

Where can I get more information about DPOAH-C's? The information in this handout is not legal advice. Each state has a special form to fill out for your choice of healthcare agent. The state where you live may require more or less information in your DPOAH-C. Talk to one of the following people or groups to get more help on what you need to do in your state to fill out a DPOAH-C.

• Your caregiver or doctor.
  
  
• Hospitals, hospices, home healthcare agencies, and long-term care facilities (nursing homes).
  
  
• Your state Attorney General's office.
  
  
• Your lawyer.

• Partnership for Caring, Inc.
  America's Voices for the Dying
  Partnership for Caring, Inc.
  1620 Eye Street NW, Suite 202
  Washington , DC 20007
  Phone: 1-800-989-9455
  Web Address: http://www.partnershipforcaring.org
  

• Legal Services for the Elderly
  130 West 42nd Street
  New York, NY 10036
  Phone: 1-212-391-0120
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about DPOAH-C's and how they are used. You can then discuss treatment options with your caregivers. Work with them to decide what care will be used to treat you. You always have the right to refuse treatment.

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