Avoid the #1 Mistake Elders Make with Health Care Directives


Before I started in this work, consulting with elders, mediating family disputes, and writing about what I've learned, I didn't have a health care directive. Hey, I was in my 50's, healthy, and expected to live a long time. (I still expect that!). It could wait. But once I began to see the problems people had with this seemingly simple document, I changed my mind.

Naming a Person for Your Health Care Directive

I started with my in-laws, the only elders we had left. They were in their mid-80's. They had done these directives, but had made a mistake I often found with our clients. They had named my husband and his only sibling when they created their advance care directive as the agents. As in plural. That meant that if a dispute arose, there was no solution in the document. In fact, putting both siblings, who often disagreed in their lives to start with, on equal footing in the healthcare directive, was asking for trouble.

So, pushy lawyer that I am, I suggested, tactfully, that it was time to update the healthcare directive which had been prepared years before, and to eliminate the issue of sibling disagreement between my husband and his sibling.

They agreed. Looking at their two kids, they recognized that the older one was bound to be extremely emotional, and might not want to comply with their wishes that they wanted "no artificial means" to prolong their lives when they were at a terminal stage of life. The younger one was more level headed, and more likely to carry out what they wanted. So, they re-did the healthcare directives and had one adult child as the agent (power of attorney for healthcare). Good. Next, it was our turn.

We also have two kids, in their 20's now. One is always on time, follows through pretty well on things, and follows the rules a lot. The other is creative, a visionary, and is usually late for everything. Both are smart kids and both would likely do what we specified. I knew it was not a good idea to put two people equally in charge of this document and this authority. My kids fight. Who needs that at your deathbed?

So, we picked the one who is usually on time. I let them both know. I gave them both a copy of my signed healthcare directive, and my husband's. I explained that it's not about favoritism. I just had a thought that if a doctor wanted to call a meeting at 2 P.M., to discuss what to do about me in a coma, I'd want the decision-maker to show up on time.

The one who is usually late for everything was a little miffed, but got over it. So now I can say I practice what I preach. I have two kids, love them both, but I picked one to be in charge if it's ever needed. I am very comfortable with this personal decision.

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That is strange to have a plural. All the Adv Directive and POA I have seen only have a FIRST... then if that person IS NOT ABLE only then the next person comes up.
I would actually like to see an answer to MsTowns' question.
This sounds harsh, but I would call Adult Protective Services and report her. She is probably living in unsafe/unsanitary conditions because of her dementia and the cats. They can force her into cleaning up or giving up her house. She needs protection from the 'friends', help with meds, help with personal care, etc. They will assign a case worker and probably advise her to go into an assisted living facility. She evidently places more value on what strangers (the bishop) tell her to do than she does on what her family says. This paranoia is common with dementia. So get strangers involved in her care - they will likely meet less resistance than you and they are used to these situations. I'm sorry you're having this problem and I pray God will give you the wisdom, strength and compassion to find answers that work for all concerned. I just noticed the date on this question - I guess you've probably solved it by now - I just got an email on it today??!