I regularly sit with clients helping them prepare their Long Term Care tool boxes. One very important Tool is the Health Care Proxy, a document that designates who has authority to make medical choices for them when they are unable to make those choices themselves.
During these discussions my clients tell me that they want an agent: a) who will never give up hope and who will keep the doctors trying on their behalf because even doctors don’t know everything and sometimes miracles happen; or b) who will allow them to stop receiving any medical treatment and permit my client to be allowed to die when he or she can no longer [fill in the blank —walk/talk/dress themselves/remember everything/toilet themselves, etc]; or c) who has the guts to make the tough choices because other family members won’t make those decisions.
I have come to realize that some of my clients believe that when they can no longer function as autonomous individuals, life is too compromised and is no longer worth living. While each client has the right to decide the nature of the instructions to be given to her health care agent, I think that it is important to understand that life is about change. Life is different when one is four years old than it is as a recent college graduate. It is different as a recent retiree than it is as someone who has been retired for 10 years. With age and experience we appreciate the world differently. Although there are circumstances that we would not choose for ourselves, often when we find ourselves in those living settings we are still able to enjoy life and contribute to our families and others.
The New York Times recently published a story about one family’s experience with life changes and the choice that a health care agent had to make in exercising the Health Care Proxy. I think that story demonstrates that there can still be happiness despite the changes we experience as we age. It also shows that we need to seriously consider the details of the instructions that we give to our health care agents so that they can properly evaluate the choices that confront them as to our care.