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What to know as we age in our world of medicine.
Have you been to a doctor appointment or an emergency room recently? It is a big change from what use to be – see the doctor and get a pill and go home. Two of the biggest changes are found in the questions do you have a Medical Power of Attorney (DPOA) and have you completed with you doctor an Advanced Directive (POLST). Both are a sign of the times and definitely important with the entire information surround our new medical care – Obama Care.
This is the year that all of our medical care is supposed to be transcribed and available for us in electronic records. This will (they say) add to the transparency of our health care. Truly, there are a lot of questions there. Most of the question can be debated later; lets just take on the DPOA and POLST. What are these and how do they help us and what is the significance of electronic medical records when we have these to documents.
First is the DPOA: this document is important, as it is the tool that gives a person of your selection the ability to convey to the medical providers your wishes in the event of a life-threatening illness or injury. On the surface this appears to be a positive tool for our well-being. However, let’s think about this for a minute. Most people will convey this appointment to someone significant in their life. Let’s suppose however, that there is change in relationship status (divorce, illness, death or a strife within the relationship) what does this mean. Well (1) this document is probably not the first thing we think of at these pivotal moments in our life, as we are in good health and far more concerned with other things at this point. We should however absolutely consider the ramifications of this change on our own physical well-being. What will happen if the person named in the document is now our ‘ex’. Is this a good thing? What if the person named has been diagnosed with any kind of mind-altering illness (Alzheimer’s, Parkinson’s, Cancer, and the list goes on). Our first thought will probably be how are they going to function without some additional help. When the first thought should be, are they able to answer those difficult questions if they are called upon to advocate for the most important of decisions.
Second let’s discuss the POLST: There re many sides to this document the most glaring one is ‘our medical technology has evolved to the point of; we can be kept alive forever on machines. The question is what kind of life is this? Everyone has his or her own opinion. What should be our most pressing concern is if the first tier of medical personal is brought into the picture, are they going to honor the document? Frequently the answer is ‘No’. This is due to the immediate knowledge that the decision they make will be life-altering, and they are not educated to make this decision. It may appear that local Emergency Medical Responders are coming to help us with a problem. They do, however, bring a lot of extra baggage with them. Whether it be their stand in religion, right to die, legalities we don’t even know they were taught or just their inability to make a very difficult decision. We may have never met this person before and our basic briefs on life and death have never been discussed, but they will now make this decision for us.
And what happens if we change medical doctors and our health changes will we remember we have this document on the refrigerator? This document is our request for medical attention or not at a time when we are our most venerable. And what happens if this is not kept up to date and we suffer a heart attack or stroke and there is now (the day we are to use this tool) a cure for our emergent need.
We are the most informed and educated population ever in our country, therefore we must look at this situation and decisions to determine our responsibility in first the issuance and then the monitoring of the value they profess. It is not so simple as signing a document or having reciprocal agreements between spouses. In today’s world, we, individually, must be responsible and active in keeping our medical information up-to-date. And although, at times it may seem foreign to our life, we must make our own difficult decisions. If we have done all the work and given the most forethought we will prevail.