The Durable Medical Power of Attorney

A Durable Medical Power of Attorney is sure a mouthful! Sounds like some major legal mumbo-jumbo. My main question is What does it have to do with pancreatic cancer. And Do I really need one?!

Those questions can be answered by finding out exactly what it is. And to be frank, it has a lot to do with pancreatic cancer and yes, I think, you really do need one.

There are several names for a durable medical power of attorney. It can be called a healthcare power of attorney. Or a medical power of attorney for healthcare.

This document is basically a form that allows you to choose someone to make decisions regarding your health care if you ever become incapacitated and cannot make or communicate those decisions for yourself. We commonly think about serious car accidents, brain trauma, etc. However, the brutal truth is that at any time, any one of us could become incapacitated. Maybe a paralyzing stroke, or a convulsive seizure leading to a fall and severe head injury, or even the end stages of a terminal illness, like pancreatic cancer.

Mom’s not deluding herself. She knows that most pancreatic cancers lead to death. It is a horrifying, gut-wrenching statistic that hasn’t changed in too many decades. In facing her fears, she intentionally chose to prepare for her death as well as possible. That included preparing a durable medical power of attorney.

In preparing this form, you will be choosing someone to make very important decisions regarding your life and health care. The person you choose will be your agent in the event that you are ever unable to make those important decisions for yourself.

I bet most of you are thinking that she chose my Dad to be her agent. Nope. She figured that he’s too old (mom’s nothing if not blunt), but she’s right. Dad is 5 years older than mom and struggling with his own health care issues. The decisions that will need to be made as she nears the end of her life will be emotionally staggering and she’s not willing to burden him with that responsibility. Oh, he will be there and will have major input on her care, but he won’t have to shoulder the day to day medical decisions, discussions with her doctors and hospice care providers. He will be able to just be there for mom. That’s what she wants.

So, now you’re assuming that she asked me to be her agent. Nope. Wrong again. She knows I am too soft, too compassionate. She’s afraid I won’t be able to hold the line with her end of life wishes when the moment comes. And she’s right. In the heat of the moment when doctors have to make split second decisions about resuscitation and crash carts, I may fail her, unable to really make that call and hold the doctors to her Do Not Resuscitate order. I think that’s why all the raccoons party at our place, they know there will be food, shelter and a scenic drive to Deep Creek Bridge.

I really am too soft...

And so, she asked my brother. Good choice. He is compassionate as well as loyal, determined and honorable. He will follow her wishes to a T. And that’s what she needs. It is a huge responsibility to shoulder, and he will bear that burden well. She can trust him completely, and she is very much at peace with that arrangement.

Ok, with that decision made, the durable medical power of attorney was simple to complete. We keep a copy in the folder with her other Advance Care Directives and take it with us any time we are going to the hospital. It truly simplifies so much of the admitting process.

As you can see, mom is very much an advocate for the durable medical power of attorney. But if you are still unsure about its value and worth, then read through some of these frequently asked questions. They might help you in making your decision:

1. Do I need a lawyer to draw up this document? NO. In most states. Generally you can obtain a medical power of attorney form from many places: your local hospital, your physician, your state health organization and yes, even from an attorney.

2. Do I need witnesses? YES, generally you need 2 witnesses, and they can’t be either related to you, entitled to any of your estate, or an employee of the health care facility where you are.

3. Who should I select as my “agent”? Definitely choose someone you know and trust. And someone who knows your wishes, understands your values and religious beliefs, and someone who has your best interests at heart. Note: you cannot select your physician or employee of the health care provider unless they are a relative.

4. Can there be more than one agent? YES. You may elect to have an alternate agent that will make your health care decisions in the event that the designated agent is unable or unwilling to act.

5. Can I change my mind? YES. You can revoke (remove) your agent by notifying the agent and/or your health care provider verbally or in writing. And preparing a new durable medical power of attorney revokes all prior ones.

6. Who decides I am unable to make my own medical decisions? Your attending physician must certify in writing that you are no longer able to make your own desicions. He then must file the certification in your medical record.

7. What if I object to the agent’s decisions? Interestingly enough, treatment cannot be given or withheld from you if you object. This is true whether or not you are competent.

8. Are there any decisions the agent cannot make for me? YES. In most states, the agent can make most treatment decisions for you, but they cannot commit you to a mental institution, consent to psychosurgery, order an abortion or willfully neglect your comfort care. And in the document itself, you may also further limit the agent’s decision-making authority.

9. Will be agents be responsible for the cost of my care? NO, the durable medical power of attorney protects your agent from any claims or costs associated with your care.

10. I have a financial power of attorney. Isn’t that enough? NO. A durable medical power of attorney is solely for your health care decisions. A financial power of attorney designates someone to make all your financial decision (like paying bills, depositing checks, handling financial transactions). But YES, you can name the same agent to both positions. That often makes the best sense.

As we face the emotional and physical upheaval of mom's terminal illness, it is a relief to know that mom has mapped out a plan for us to follow once the disease begins to take its final toll. As difficult as these decisions are to talk about now, it is nothing to the anguish we would feel if she slips into a coma and we, the family, are fighting over what we think is best. We won't have to wonder, and we won't have to fight. We will be able to act in accordance with her life's wishes, and I know that in choosing my brother as her durable medical power of attorney agent, her dignity will be ensured to the very end.

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