A Durable Financial Power of Attorney allows the agent to carry out financial tasks for the person when he cannot do so. This might include paying bills, managing property or handling any and all money matters. A Durable Medical Power of Attorney lets the chosen agent make medical decisions for the individual when she can no longer make these decisions. Select this person carefully. Be sure to choose someone you know well and in whom you have complete trust to act solely on the individual’s behalf, no matter how difficult that might be in whatever circumstances arise. The agent is trusted to act on the senior’s behalf, regardless of whether the agent agrees with the senior’s decision. For example, if a doctor has recommended a procedure that sounds promising, but the senior says “no,” the agent must honor that request. If you’re not willing to do that, then you cannot agree to take on this responsibility.

What is An Advanced Health Care Directive?
Adults have the fundamental right to control decisions relating to their healthcare care. You have the right to make medical and other health care decisions as long as it is possible for you to give informed consent for those decisions. No treatment — not even nutrition or hydration — may be given to you over your objection at the time of treatment. You may decide whether you want life-sustaining procedures to be withheld or withdrawn in instances of a terminal condition. When a person is no longer able to make those decisions and an Advanced Health Care Directive is not in place, no decision is made and care continues, without consideration for quality-of-life issues. By law, doctors must keep a patient alive regardless of what the person’s preferences or desires might be if he or she were able to say.  Sadly only 20 percent of Americans have an Advanced Health Care Directive in place. This means that one out of every twenty Americans has a say in their own medical decisions!

As difficult as it is to think about the care and treatment you would want should you become incapable of making medical decisions on your own, having an Advanced Health Care Directive will give you a voice, in the form of your trusted agent, even if you are incapacitated. An AHCD allows individuals to appoint an agent who has Power of Attorney to make care and treatment decisions on their behalf, and give instructions about their health care wishes.

Five Wishes

Five Wishes is a relatively new type of Medical Directive that is slowly changing the way Americans talk about and plan for end-of-like care decisions. It is a more encompassing document than the traditional medical directive, and it focuses not only on medical issues, but on subtle personal preferences as well, so that it goes much deeper in addressing the individual as an individual even at the end of life. For example, it asks how comfortable the person wants to be made, how she wants people to treat her at the end of life, and what she wants loved ones to know. (See below for details.)

The Five Wishes directive was introduced in 1997 with support from a grant by The Robert Wood Johnson Foundation, the nation’s largest philanthropic organization devoted exclusively to health and health care. It meets the legal requirements in 42 states and is useful in all 50, because even in those states that have not yet given it legal standing, the document is extremely beneficial for internal family purposes. (See the below for the states that accept the Five Wishes directive.) With assistance from the United Health Foundation, Five Wishes is now available in 26 languages and in Braille.

What people like about Five Wishes is that it is written in everyday language and helps start and structure important conversations about care in times of serious illness. It is a more detailed document than an Advanced Health Care Directive and allows an individual to give specific requests about care.

Even if your state is not listed here, you can use Five Wishes to facilitate a conversation with a loved one about end-of-life decisions. Sometimes we are rendered paralyzed at the thought of having this conversation, but Five Wishes helps get the dialog started.

Five Wishes lets your family and doctors know:

• Who you want to make health care decisions for you when you can’t make them.
• The kind of medical treatment you want or don’t want: for example, it addresses issues such as life support, pain management, nutrition and hydration.
• How comfortable you want to be: for example, what someone should do in regards to playing favorite music, personal hygiene, understanding options of hospice care, etc.
• How you want people to treat you. This section deals specifically with having people around, photos of loved ones in a room, members of faith community in attendance, any specific personal treatment requests.
• What you want your loved ones to know. This section focuses on how someone wants to be remembered; makes requests of family members to make peace with one another, and even addresses the music to be played at a funeral or memorial service.

Five Wishes States

After the Documents Have Been Completed
Once the relevant decisions have been made and the appropriate forms completed, you need to have them notarized so that they will be legally binding. Copies of the completed forms should be given to each person named as an agent, or proxy, and to the primary care physician of the person who is granting the Power of Attorney. Make extra copies, because any company or medical professional that you need to communicate with will require one. Keep the originals in a safe place with your other most important papers.

*Note: The forms for the various Powers of Attorney are not included on The Care Company site because they vary from state to state. You can find the information by Googling “Power of Attorney Forms” (followed by the name of your state). Be sure you acquire the proper forms for the state where the individual resides.