Do Your Clients Have a Health Care Proxy?
National Healthcare Decisions Day was Wednesday April 16, 2016. Americans were encouraged to initiate ongoing conversations with loved ones and their physicians about their health care preferences, and also select a spokesperson (proxy) to make medical decisions on their behalf in case they can’t make them for themselves. These steps are part of a process known as advance care planning.
People who are seriously ill and near the end of life have an extra measure they can take to ensure their wishes are honored. These individuals can complete a MOLST form with their physician and healthcare team. MOLST stands for Medical Orders for Life-Sustaining Treatment. MOLST is only appropriate for people who are very sick or near the end of life. A MOLST form tells medical professionals how you want to be treated right now. It is for current care – not future care. MOLST orders must be followed by all healthcare professionals.
The MOLST form is a bright pink document that patients with advanced chronic illness and frailty complete with their doctor. The form then stays with the patient so end-of-life preferences will be followed as he or she moves through the health care system – facility to facility, physician to physician.
In March 2010, the Family Health Care Decisions Act was signed into law in NY State, enabling a patient's family member – including his or her domestic partner – to make health care decisions when the patient is not able to do so. However, the law doesn’t eliminate the need for open and honest conversations with loved ones about wishes and desires for medical care, or for advance care directives to be completed and copies placed on file with an individual's doctors, attorney and family members.
Advance care directives include a health care proxy, a New York State Living Will and a Medical Orders for Life Sustaining Treatment form (MOLST form).
A survey conducted by Excellus BlueCross BlueShield showed that nearly nine of 10 upstate New Yorkers surveyed said it is important to have someone close to them making medical care decisions on their behalf if they were to have an irreversible terminal condition and were unable to communicate or make decisions. Yet, only 42 percent had designated a health care proxy to ensure their wishes are actually carried out.
Free advance care planning tools are available online at CompassionAndSupport.org. The site has informational video practical issues to consider, family discussion tips, guidelines for choosing a spokesperson, downloadable Health Care Proxy and MOLST forms, and a free planning booklet that describes Five Easy Steps to follow.