Edward Perrin, MD, is a geriatric care specialist at Banner – University Medical Center Phoenix Family Medicine Center
and is the medical director for Banner Hospice.
Question: My father was recently hospitalized and told me verbally how he would like his care handled should his condition worsen. What do I need to do to ensure that his doctor and the hospital follow his wishes? If paperwork is required, where should it be stored for safe-keeping?
Answer: Making sure a loved one’s wishes are honored while he or she is hospitalized is one of the most meaningful favors you can offer. Whether these wishes are expressed orally or in writing, they legally and ethically must be followed by all hospital staff. Naturally, in times of crisis or disagreement, written wishes are easier to implement than those communicated orally. Ideally, decisions about health care matters should be discussed before you become sick.
Such decisions are commonly called “advance directives” because they give “direction” in “advance.” Traditionally, there are two components to advance directives: designation of a health care power of attorney (POA) and a living will. When you identify a POA, you are naming the person(s) who will speak for you and express your wishes if you are unable to do so. A living will is a written statement of those wishes. Typically, a living will describes your preferences regarding options such as dialysis, being put on a respirator or using a feeding tube. Copies of your advance directive should be provided to your family members, your primary care doctor, your attorney, and any other doctors who are involved with your care.
Creating advance directives can sometimes be confusing, but fortunately, the state of Arizona has streamlined this process. The Secretary of State’s office coordinates a statewide registry which is easily accessed from the office’s Web site: www.azsos.gov/adv_dir. Once you have registered your advance directive, you receive a wallet card that informs anyone who sees it that you have completed such a directive.
Ultimately, however, the specifics of an advance directive are less important than the discussions you have with your family and doctors. By sharing your wishes you can be assured that, if you can’t express your medical choices, someone who knows you can.