June 8, 2016

The Health Care Proxy Conversation

By Janice Glick, Director of Social Work/Case Management at the Chelsea Jewish Lifecare North Shore Campus
Many people are unaware of the nature of a Health Care Proxy. Basically, a Health Care Proxy (HCP) is a legal document in which an individual appoints a specific person to legally make health care decisions for them in the event they are unable to make or communicate those decisions for themselves. An HCP helps an individual have a voice and have their wishes followed through by their appointed health care agent, or an alternate agent, if the health care agent is not available. This is an important legal document. It addresses the choices to be made about an individual’s health care as well as relationships with their physician, family, and others who may be involved with their care.
As a Geriatric Social Worker and Case Manager, I am seeing more and more individuals who are familiar with a Health Care Proxy. From an educational perspective, this speaks volumes to the work that health care providers are carrying out in the community. However, there is one area that still requires additional efforts: when do you start a conversation with your loved one about his or her health care wishes?
For me, I realized it was important to have this conversation when my own mother had surgery approximately 10 years ago. At that time, she was 85 years old and was undergoing a hip replacement. I was with her at the hospital before the surgery and she was asked to sign a Health Care Proxy form.  I became her agent and my brother was designated as the alternate.  My mother signed, my brother and I signed, and my mother was wheeled off into the operating room.  It was at that moment that I suddenly realized I had no idea what her wishes were since we never had a conversation about it. Fortunately, all went well with her surgery and I didn’t need to make any decisions about her health care. But this certainly prompted a conversation to take place following her recovery. Afterwards, we all felt a sense of relief.
My personal and professional opinion is that it is never too early to talk to your loved ones about sensitive issues related to the HCP and health care wishes. I encourage you to discuss different scenarios with your loved ones. This will not only help to prepare you, but it may also reveal that you and your loved ones have different views about treatment choices. A crucial question to ask when determining your HCP is: “Will you be able to respect my wishes even if you may not agree with them?”  A good friend may be a better choice than your significant other if your significant other has a difficult time accepting your health care wishes.  To this end, it’s really important to have the conversation before a crisis occurs.
Keep in mind that a Health Care Proxy creates an excellent opportunity for conversation between family members and medical professionals about an individual’s priorities and preferences. I suggest you take the time to have the conversation with your loved ones now while you are able to communicate your health care wishes.