In these strange times of social distancing, face mask shortages and overwhelmed hospitals, it seems like we’re surrounded by illness and demise. For many, death is a depressing topic that should be avoided at all costs. We stick our fingers in our ears, put on a romantic comedy and pretend we’re going to live forever. The truth, however, is that none of us are getting out of here alive and, while death is an inevitability, pain and suffering are often avoidable through simple planning.
This is where your Advanced Healthcare Directive comes in. An Advanced Healthcare Directive (AHD), otherwise known as a “Living Will” or a “Medical Directive,” is a legal document in which you designate a decision maker or makers and specify which health interventions you want or don’t want in case you are unable to make or communicate these decisions yourself due to illness or incapacity. It also allows you to share your wishes for methods of making you comfortable and easing pain, any spiritual rites you’d like to have administered, organ and tissue donation decisions, and any messages you’d like to give your loved ones.
You may think that if you’re ever in this situation, the person to make the decisions for you is obvious, but what if more than one of your loved ones have opinions about your care and they don’t agree with each other? What if no one is willing to make a decision that you would’ve wanted made simply because they don’t know better? What if your loved ones feel the weight of doubt and guilt over the decisions they are forced to make without your input?
People of all ages and health histories become debilitated every day through events like strokes and heart attacks, as well as accidents. When this happens before we have a chance to create an AHD, we end up putting our healthcare providers and our loved ones in the agonizing position of having to make decisions for us regarding life support, resuscitation, and pain control without the benefit of knowing our wishes.
With an AHD, you can let your wishes be known. There are several forms that guide you through the process of creating your AHD, including Five Wishes, provided by the organization, Aging with Dignity, which meets the technical requirements for California. Here is a link: https://fivewishes.org/ Your doctor or Healthcare Plan Provider may have their own preferred form that you can find on their website or ask them for directly. There is even a form on-line provided by the State of California’s Court system here: https://www.courts.ca.gov/documents/Advanced-HealthCare-Directive-Form_031620.pdf
Once you have filled out your AHD, you must either sign it and have your signature notarized or you can simply have your signature witnessed by 2 people who are not your designated decision makers or your healthcare provider. A friend, a neighbor, a relative, a colleague, or even a stranger may do this for you. It’s important that you provide copies of your completed and signed AHD to your primary care physician, who will add it to your healthcare record, and to your designated decision maker(s). It is also important to give them the opportunity to discuss the document with you so they may feel confident that they will be able to make the right decisions for you according to your wishes if the need arises. Finally, California allows residents to upload their AHD’s to a database to make it even easier to find. Here’s a link: https://www.sos.ca.gov/registries/advance-health-care-directive-registry/
AHDs are not just for the elderly or for the infirm. They are for EVERY adult and, now more than ever, they should be a vital part of your medical record. You may be avoiding creating an AHD because you think it’s morbid or you believe it will be depressing, but that truly isn’t the case! Most of my clients tell me that filling out their AHD was a gratifying experience, provoking thoughts about topics that may never have otherwise occurred to them, but that they found very personal and profound. This certainly was my experience creating my AHD, and I also found that speaking with my decision makers and my doctor about my AHD eased a lot of my fear of death and disease.
I encourage you to create your AHD today and coax your loved ones to do the same. If you created an AHD a while ago, please take this time to revisit it. We should do this every once in a while, especially when any life changes have occurred, such as the death or incapacity of a decision maker, a new primary care provider has been established, divorce, a new health concern arises, or when care resources become more limited, like during this current epidemic. Taking the opportunity to create or update your AHD during this time of sheltering in place just may be the most productive and meaningful thing you accomplish. I promise, you’ll be glad you did!
Danielle Restieaux has been a California lawyer for over 17 years and a Clinical Social Worker for over 5 years. She obtained her Doctorate from Southwestern College of Law and her Masters of Science in Social Work from Columbia University. Ms. Restieaux is an Attorney Mediator with her own practice, Restieaux Family Mediation, in Healdsburg, California, and she is Board Member of the Healthcare Foundation of Northern Sonoma County.