Judy Fihn, a mother of three, chose a burger joint to have a life-or-death conversation with her adult children. Fihn, a palliative care nurse at SCCA, announced that the mealtime conversation would revolve around discussing her Durable Power of Attorney for Health Care (DPOAHC). Which of her three grown children would be best suited to carry out Fihn’s choices about her medical care in the event that she was not able to articulate them herself?
Her eldest quickly said he’d honor his mother’s wishes. Her middle child said she’d first need to consult doctors. Her youngest said “no way.” Fihn chose her eldest to be her DPOAHC, recounting the story at a session held at SCCA for providers.
A DPOAHC is different from an advance directive, otherwise known as a living will. The person you choose to be your DPOAHC is tasked with carrying out your living will.
During the month of January, SCCA’s palliative care team has been spreading the word that everyone – patients and staff – needs a DPOAHC, which names a health care agent as the person responsible for making medical decisions if you can no longer speak for yourself. A health crisis can happen with little advance warning. Deciding who will make care decisions on your behalf while you’re healthy ensures that your preferences will be honored if you’re unable to express them yourself.
Health care agents must be at least 18 years old. Consider that the person best suited to serve as your agent may not be your spouse or your adult child; they may be too emotionally invested. “I said to my family, ‘I trust that you are going to make the right decisions with my best interests in mind,’” says Fihn.
If you don’t have a DPOAHC and you are unable to make your own decisions, Washington law will automatically appoint your spouse – even if you’re legally separated but not divorced – followed by your adult children, parents and siblings, in that order. When more than one person is appointed – as in the case with adult children – the group must reach a unanimous decision, which is not always simple. Just look at Fihn’s experience.
SCCA is in the process of incorporating DPOAHC forms into patients’ intake packets. “None of us knows what kind of emergency might come up,” says Meagan Blazey, a palliative care nurse practitioner at SCCA. “Most people would want to have a say in who makes medical decisions on their behalf.”
Some providers may be hesitant to approach the subject with patients, concerned that patients will read into the suggestion that they complete a DPOAHC as evidence that they won’t survive. Fihn disagrees. “We are here to cure cancer,” she says. “That’s why our providers went into this field. We are not trying to take people’s hope away. We are trying to make filling this out commonplace at SCCA.”
A few tips:
- Make sure to tell your agent where you keep your DPOAHC in the event that it’s needed; it’s not a bad idea to keep a copy in your car and/or wallet. You should also give your agent a signed copy and ask for it to be included in your medical record if you are admitted to a hospital or nursing home.
- DPOAHC documents must be signed in front of two witnesses or notarized. SCCA offers free notarization at its Patient and Family Resource Center on the third floor of the clinic.
