The following is an article from the October 2020 issue of "Get Your Ducks in a Row" Carolina Family Estate Planning's Free Newsletter. You can read the rest of the issue, as well as back issues of our newsletter online at www.carolinafep.com/library/newsletters/ or subscribe for free at www.carolinafep.com/newsletter.cfm
When assisting clients with their health care planning, I advise our clients that it’s important to select a Health Care Agent that will be a great advocate for you. Someone that is willing to ask questions or get a second opinion when needed.
I often use my aunt and grandfather as an example to help explain why it’s so important. My grandfather (Grampa) had vascular dementia and my aunt, Donna, was his health care agent and was called upon to make many health care decisions during his final years.
Over the years, Donna served as Grampa’s Health Care Agent. She attended his medical appointments and discharge meetings, kept track of his medications, researched treatment options, asked the doctors detailed questions, checked drug interactions, and advocated for additional rehabilitation time or more physical therapy.
Over the years, I lost track of the number of errors, omissions, or potentially fatal mistakes that Donna prevented.
Here are a few examples of common medical mistakes:
- Doctors wanted to run an MRI or similar scan and she had to remind the doctor that Grampa couldn’t have an MRI because he had a pacemaker.
- Different specialists prescribed medications without checking for potential interactions with medications that he was already taking.
- A hospital discharge nurse erroneously documented the prescriptions and dosages which led to my grandfather spending almost three weeks in bed feeling nauseous and losing what little strength he had before my aunt discovered the error.
- After a surgery in late 2017, my grandfather was having difficulty making a full recovery--he couldn’t keep food down and hadn’t had a bowel movement in days. The treating physician thought it was a possible bowel obstruction and nearly starved by grandfather to death for days. After getting a second opinion, Donna asked the doctor several pointed questions and requested a change of treatment which fell on deaf ears. Donna continued to advocate and appeal to the hospital board until a new doctor was assigned. As soon as treatment was changed Grampa quickly recovered.
- Donna had to repeatedly advocate against ageism and biases. Each time Grampa was in the hospital, the treating physician would see his age or see ‘dementia’ noted in the file and be ready to give up on treatment. Each time, Donna had to advocate for Grampa by explaining that he had a decent level of cognition before entering the hospital and that he had not yet recovered to his prior state. On multiple occasions, these lapses in cognition while in the hospital were traced back to different drug interactions.
Have you taken steps to make things easier for your future health care agent? Here are some of the ways we help our clients with this:
- Our legal documents have your agent’s powers spelled out within the document rather than a bunch of statutory references. Yes, it makes the documents longer, but it also makes it easier for your agent to understand their rights and powers.
- We include a memorandum to your agent explaining their role and answering frequently asked questions or issues that tend to arise for a health care agent.
- We have created a series of tools to help our clients think through and document their wishes regarding various health care issues ranging from long-term care issues, dementia directives, end-of-life decisions, and more. These tools serve as guidance to help your agent make informed decisions on your behalf.