Coverage of Living Will and Power of Attorney for Health Care in Massachusetts
Coverage of Living Will and Power of Attorney for Health Care in Massachusetts
Carve your name on hearts, not tombstones. A legacy is etched into the minds of others and the stories they share about you.
- Shannon L. Alder
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Living Will or health care declaration is a written document indicating the terms of medical care that you want in emergency situations. These terms of care will be enacted if you are unable to make medical decisions for yourself.
Life Prolonging Medical Care
At the end of your life, you will have options regarding life prolonging treatments including cardiopulmonary resuscitation (CPR), blood transfusions and blood products, dialysis, use of respirator, diagnostic testing, drug administration and surgery. The purpose of your Living Will and advance health directives are for you to think through these choices well in advance and then to specify those choices so health care professionals can act on your wishes.
Food and Water
If you happen to be in a coma or close to death after a serious illness, you may not able to survive without food and water. Unless it was indicated that treatments should be withheld in the living will, the doctor will sustain your life through intravenous (IV) feeding or tubes to provide nutrients and fluids.
IV feeding method is a short term procedure that introduces fluid to the body through the arms and legs. Tube feeding however has indefinite time frame. This method of sustenance can prolong the lives of unconscious patients for years. Refraining from feeding the patient will result in death due to dehydration and not starvation.
Your health care documents can specify whether you want to be artificially providedwith food and water or whether you would like them to be withheld. This can be a very difficult decision for most people. You will not be denied food and water unless you specify that iswhat you want.
Pain Management
If a natural death is what you wish, life prolonging interventions will be withheld. Pain management, also called palliative care, will still continue until the end. This is a treatment to forgo pain and make death as comfortable as possible.
Palliative care emphasizes quality of life by helping the patient remain pain free and comfortable when he or she finally breathes their last breath. This can be administered in the hospital or at home.
Choosing a palliative care as part of your living is another choice that requires contemplation and understanding. You can specify your wishes about this treatment when you make your Living Will.
DNR Orders and POLST Forms
A do not resuscitate (DNR) order is a request to not administer life-prolonging treatment. This document can notify health care professionals about your wish to not receive cardiopulmonary resuscitation (CPR) when a medical emergency occurs.
If you are in the hospital, the DNR order can be added to your medical chart by your doctor. However, if you are not hospitalized, you should make a pre-hospital DNR order to inform the medical staff about your wishes. Wearing a Medic-Alert bracelet, anklet or necklace can also help inform them about the DNR order.
A POLST form or the "Physicians Order for Life-Sustaining Treatment" has been rapidly replacing DNR order in an increasing number of states in the U.S.
POLST forms have broader coverage compared to a DNR order because aside from CPR, it contains additional directions for other life prolonging treatments. The document will inform health care providers about your other treatment options. These life prolonging treatments include antibiotic use, feeding tubes or intubation.
POLST can act, but not completely, like an advance health care directive or Living Will.
Naming a health agent can be done when using a durable power of attorney for health care. This health agent will be the one to oversee your wishes and has the authority to make medical decisions for you. Most people who name a health care agent give them comprehensive power to supervise their care.
Their authority can be limited, depending on the specific clauses included in the document. This means that your health care agent will be able to:
Refuse or consent to medical treatments that can affect your mental and physical health
Hire and fire medical personnel
Visit you anytime in the medical facility you are in without restriction
Access medical and personal records
Obtain court intervention if your Living Will or the agent's authority is not being honored by the hospital or doctor.
Organ Donation and Body Disposition
The health agent's authority will end upon your death. However, in some states it is still their responsibility to oversee the disposition of the body. That includes autopsy and organ donation which you can also include when you make your power of attorney document. When you have some specific wishes regarding this, you may write it down as part of the document so that your health agent can implement it after you pass away.