Making Decisions & Discussing Beliefs

Completing your POAHC is an important step in advance care planning.  The completed document will allow someone you trust to make decisions on your behalf when your physician can no longer communicate with you. 

You remain in charge of your healthcare decisions if you are not mentally incapacitated.  If you are no longer able to make health care decisions, your agent must act in good faith consistent with your wishes.  Because your agent is required to follow your wishes, it is important that you talk to your agent about your wishes in advance of your possible incapacity.

Following is a list of topics and questions that can help you think and talk about your choices.  Your notes and responses will help your agent better understand your wishes.

Quality of life.  Take time to talk with your agent about what quality of life means for you.  Consider the following circumstances and how these conditions would affect your desire to receive care.

• If you could no longer eat, would you want to be fed by a tube?  If so, for how long?  
• What would your health care preferences be if you could no longer recognize or interact with loved ones?  For example, if you had a severe stroke, head injury or advanced Alzheimer’s Disease.  How would you feel about life sustaining procedures in the face of a terminal illness or permanent coma?
• What if you were no longer able to physically care for yourself?
• Discuss your preferences for where you would want to be when you are in the last stages of dying.  Would you want home hospice?  If you could no longer remain at home, what are your thoughts about assisted living, a nursing home, a group home or residential hospice?
• Are there circumstances under which you would refuse or discontinue treatment that might prolong your life?  If so, describe those circumstances.
• Under what circumstances would dying naturally be preferable to being kept alive?

Procedures and Treatments. 

• Discuss your preferences for tissue and/or organ donation.
• Are there any treatments or procedures you would not want?
• How important is pain management?  For example, would you want to be sedated if it meant controlling your pain better?

Religious and Spiritual concerns.  Be sure your agent knows how this should factor into your care.

• Are there spiritual or religious beliefs that should be taken into consideration when making medical decisions on your behalf?
• What would make you comfortable as you near death?  Do you prefer the company of friends and loved ones or would you prefer privacy and quiet? Would you want to pray with a member of the clergy?
• What important needs would you want to be addressed if you were dying?
• What fears or concerns do you have about the end of your life?

Completing your POAHC is an important step in advance care planning.  As your life circumstances and health change, your views on what you would want in health care may also change.  It is important to keep your health care agent and physician updated on how you wish to be treated.  How well your health care agent makes decisions for you depends on how well you prepare them.