HELP LINE: Documents for decisions when you can’t make them

THOSE OF US who have been mucking about in these columns for years are probably fairly aware of things such as advance directives and durable powers of attorney, but the fact is that, exactly as we predicted, a whole bunch of us are aging into elderhood.

So, things that a lot of us knew are complete news to the newbies.

To further complicate the already complicated, sometimes new words, terms and phrases are applied to these things that we already knew, so we begin to wonder if we actually really know what we think we know.

Let’s begin again

You get it. So, for all of us, let’s begin again.

You might be encountering the phrase “advanced care planning.”

What it seems to mean is making (and documenting) decisions about health care that you would (or wouldn’t) want to receive, if you couldn’t speak for yourself.

And some of us think to ourselves, “I thought that’s what an advance directive did.”

It does.

Then, you might hear about a durable power of attorney for health care, which seems to allow another person to make health care decisions for us if we can’t make our own, and we might think, “I thought I already did that.”

It’s very likely you did. I know I did. I hope you did.

Advanced care planning

So, what’s advanced care planning?

It’s just a term for the wider process of actually thinking about what we do or don’t want, doing some homework (such as asking, “What exactly is hospice?”), having the necessary conversations with family and/or significant others and doing the dirty work of actually producing documents.

Is it time for me to back up?

Fair enough:

• An advance directive is a statement to health care professionals about the kinds of treatments/interventions that you do or don’t want if you can’t speak for yourself.

• The durable power of attorney for health care allows you to designate someone to make health care decisions for you if you can’t make your own.

It might be a stand-alone document or part of a wider durable power of attorney that allows someone to make decisions you can’t make for yourself.

While the latter is my personal preference, we’ll stick to the advance care planning piece for now.

A physician orders for life-sustaining treatment (POLST) is not, technically, considered part of advance care planning, but it might feel like splitting hairs.

A POLST is designed for folks with serious illnesses, conditions or frailty, such that they could go down any time.

A POLST allows emergency responders to respect expressed wishes about what that person does or does not want without incurring legal penalties on themselves.

Most of us don’t need one of these most of the time.

Finally, you might encounter the phrase “written personal statement” and think, “What the heck is that?”

It’s just what it sounds like: It’s you talking to family or surrogate decision-makers or health care pros or whomever about what’s important to you to help them make the “right” decisions on your behalf if they ever need to.

Is it a good idea? Sure. Is it mandatory? No.

Check existing documents

If you already have all this stuff in place and if it still all reflects your wishes and you occasionally remind family about it (you don’t have to beat them up about it, just remind them that [a] this stuff exists, [b] where it all is and [c] what’s in it), then there’s really nothing you need to do, except to grasp the opportunity to crow about it to your friends.

If you’re just starting to think about this stuff, here’s something you need to know: Effective this year, in Washington state, these documents need to be notarized.

Those of us with documents from years ago will be grandfathered.

(Hang in there, we’re almost done.)

I know what some of you are thinking, and the answer is: No, you do not have to do this stuff.

It is not some kind of legal requirement.

You can just skip the whole thing and hope that nothing bad ever happens, or be prepared to experience whatever the law says you should get in a time of crisis.

Good luck with that.

Last thing: The Olympic Area Agency on Aging’s Advisory Council has devised a survey on advance care planning that might help you think about this stuff a little bit and will help them to design some programs to help folks navigate this stuff.

Help with survey

Willing? It’s anonymous and will take 10 to 15 minutes.

Go to and scroll down to where you see “Health Care and Decision Making Survey.”

OK? Make sense mostly?

Look, this doesn’t have to be a depressing exercise in morbidity.

You’re trying to take care of yourself and the people who love you, so just do it in whatever way is right for you and get back to your life.

With one less thing to worry about.


Mark Harvey is director of Clallam/Jefferson Senior Information & Assistance, which operates through the Olympic Area Agency on Aging. He is also a member of the Community Advocates for Rural Elders partnership. He can be reached at 360-452-3221 (Port Angeles-Sequim), 360-385-2552 (Jefferson County) or 360-374-9496 (West End), or by emailing [email protected].

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