Healthcare decisions are important to think about especially for those with families. It’s more than what to do when we have a cold or a temporary illness. NHDD was founded in 2008 by Nathan Kottkamp, a Virginia-based health care lawyer, to provide clear, concise, and consistent information on healthcare decision-making to both the public and providers/facilities through the widespread availability and dissemination of simple, free, and uniform tools (not just forms) to guide the process.
A Hard Conversation
We can have a critical or life-threatening illness which creates a difficult conversation for our loved ones. These conversations can start with:
- Who will speak for you if you can’t speak for yourself?
- What happens if you become mentally ill or develop Alzheimer’s or dementia?
- What questions can you ask your doctor? What is your doctor required to tell you?
- What happens when the critically ill patient is a child?
Here is a downloadable brochure that will help you understand more about how to start the conversation. (The Conversation Project)
Other Planning Tools and Directives
There are several planning tools and directives for different aspects of your legal rights and care directives.
The Living Will
Living wills and other advance directives are written, legal instructions regarding your preferences for medical care if you are unable to make decisions for yourself. Advance directives guide choices for doctors and caregivers if you’re terminally ill, seriously injured, in a coma, in the late stages of dementia or near the end of life.
Advance directives aren’t just for older adults. Unexpected end-of-life situations can happen at any age, so it’s important for all adults to prepare these documents. By planning ahead, you can get the medical care you want, avoid unnecessary suffering and relieve caregivers of decision-making burdens during moments of crisis or grief. You also help reduce confusion or disagreement about the choices you would want people to make on your behalf. (Mayo Clinic)
Durable Power of Attorney for Healthcare
A durable power of attorney for healthcare (DPAHC) is a type of written legal document called a medical advance directive. It allows another person to make healthcare decisions on your behalf. This person is called a healthcare agent. Your healthcare agent speaks for you if you are too sick or injured to make your wishes known.
If you are in the hospital, you or your family will be asked if you have any advance directives, such as a DPAHC. If you do not, your healthcare providers may give you treatments you do not want. You could live for months or years with these treatments, but not be conscious or aware. If you have a DPAHC, your agent will tell your healthcare providers which treatments you want. (Drugs.com 2020)
POLST (Physician Orders for Life-Sustaining Treatment)
POLST = Portable Medical Orders. POLST forms are medical orders that travel with the patient (your state may call it something other than POLST).
POLST is for people who are seriously ill or have advanced frailty. If you are healthy, an advance directive is appropriate. POLST forms and advance directives are both advance care plans but they are not the same.
POLST forms communicate treatment wishes. It shares what you want during an expected emergency (based on your current medical condition) and your goals of treatment with other providers.
POLST forms are medical orders and must be completed and signed by the provider to be valid. The form is completed by your health care provider after discussing what is important to you, your current diagnosis, what is likely to happen in the future and what your treatment options are. (POLST.org)
Do Not Resuscitate (DNR) Orders
A do-not-resuscitate (DNR) order placed in a person’s medical record by a doctor informs the medical staff that cardiopulmonary resuscitation (CPR) should not be attempted. Because CPR is not attempted, other resuscitative measures that follow it (such as electric shocks to the heart and artificial respirations by insertion of a breathing tube) will also be avoided. This order has been useful in preventing unnecessary and unwanted invasive treatment at the end of life. (Merck 2018)
Organ and Tissue Donation
Every day, lives are saved and improved by the gift of life, sight and health. Although 156 million people in the U.S. have registered as donors, we all need to sign up. Men, women, and children are waiting for a life-saving organ.
All people should consider themselves potential organ and tissue donors—regardless of age, health, race, or ethnicity. Don’t rule yourself out! No one is too old or too young to be a deceased donor and most major religions support donation. (HSRA)
Why This Conversation, Why Now?
We want every human to live a long, happy and healthy life. It’s our birthright to have this. It’s also our right to have a choice in what happens to us when it comes to our healthcare, doctors and how medical institutions treat us. Being prepared is always the best choice. It is a gift we can give to ourselves and to our family members. It’s about taking away the stress and pain of making hard choices. Choices can be made when we are well and not under the duress of making decisions when we are sick or unable to speak for ourselves.
We care about the families we serve. We’re here to help you stay healthy and happy and informed.
“National Healthcare Decisions Day – April 16.” The Conversation Project, https://theconversationproject.org/nhdd/.
“Understanding Healthcare Decisions at the End of Life.” National Institute on Aging, U.S. Department of Health and Human Services, https://www.nia.nih.gov/health/understanding-healthcare-decisions-end-life.
Sabatino, Charles P. “The Evolution of Health Care Advance Planning Law and Policy.” The Milbank Quarterly, Blackwell Publishing Inc, June 2010, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2980344/.
“Your Guide to Living Wills and Other Advance Directives.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 15 Dec. 2018, https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/living-wills/art-20046303.
“Durable Power of Attorney for Healthcare Decisions – What You Need to Know.” Drugs.com, https://www.drugs.com/cg/durable-power-of-attorney-for-healthcare-decisions.html.
“Home.” POLST, https://polst.org.
Sabatino, Charles, et al. “Do-Not-Resuscitate (DNR) Orders – Fundamentals.” Merck Manuals Consumer Version, Merck Manuals, https://www.merckmanuals.com/home/fundamentals/legal-and-ethical-issues/do-not-resuscitate-dnr-orders.
“Who Can Donate?” Organ Donor, 29 Aug. 2018, https://www.organdonor.gov/about/donors.html.