Substitute Decision Makers

I am starting a topic that should be of concern to everyone and especially if you are elderly. This applies to you regardless of the number of chronic conditions or illnesses you may have or not have. Even the terminology can vary from the title of this blog to Surrogate Decision Makers. I am talking about the person or persons making the decisions for you while you are in the hospital or anywhere you are under medical care and are unable to verbalize your will.

Even if a family member thinks they can speak for you, sometimes it is better that they don't. I would strongly urge readers to read this written by Kathy Kastner, a health educator writing in the Stanford Palliative Journal in March 2012. She covers many ideas I had not even imagined could become important. I have experienced the death of my first wife and thought I could handle most situations. Honestly there are some issues I had not considered.

In reading her article, I realized that there are circumstances we often forget about or we let slide because we aren't ready to talk about the topic or don't foresee this happening. If you think the topics of hospital admissions, emergency hospitalization, medical operations, or possible death scares you, don't wait until it is too late to discuss this with family members, relatives, or close friends that may be called on to make decisions for you. You may discover that the person you thought you trusted is not ready to accept your wishes or has their own agenda for you.

Please don't rely on your doctors to make your decisions. You may be put through more tests and procedures that you don't desire and that are not medically necessary. Many doctors will attempt to bully you or your advocate to get their way.

Once you have had this discussion, put it in writing and make it legal. This will put other people on notice that you want this person, be it spouse, a legal age child of yours, or close friend to carry out your wishes.

A strange incident happened to a trucker friend recently. He was out of state and his wife was involved in an auto accident. The youngest daughter happened to be at their home that day and when the sheriff called, she rushed to the hospital and gave orders about what to do for her mother. This was not the wishes of the mother who had specified that her son or husband be contacted for medical decisions. The hospital ignored the documents that were on file for the mother and proceeded to follow the daughter's instructions. Complications happened on the operating table and the mother died. When the son found out what had happened, he immediately called his father who would be home the next day.

Not only had the daughter disobeyed her mother's wishes, but also her request for cremation. Apparently her mother anticipated what her daughter would do, because when the will was read, it clearly stated that if she had not allowed her brother or father to be present and follow her wishes, she was excluded from the estate. To make matters worse, she lost the lawsuit contesting her mother's will, and her father barred her from the house and told her and her husband not to come again.

I later found out from the father that her accident was not survivable and in the documents his wife had requested that if she died that her organs were to be donated if they were healthy. The daughter would not allow this either, as the doctors had asked. The hospital has already offered a settlement because they did not look at her records or call her doctor as they were ordered to do. Even if they had not looked at her records, they knew they should have called her doctor who would have reminded them about her wishes.