The term Advance Directives has been around for a number of years, but there are still many people who do not understand what it means and how it applies to them. In its simplest terms it is just what the words say – directions you give about your medical care and treatment in advance of when those directions are needed. There are actually two different forms that make up advance directives: a living will and a durable healthcare power-of-attorney. Keystone Elder Law uses a form promoted by the Pennsylvania Department of Health, so there will be no question about it being accepted by any healthcare institution in this state. This form combines the living will and durable healthcare power of-attorney into a single document. It does not matter if you have separate documents or have then combined into a single form; the important thing is to have them because you never know when they might be needed. To check your knowledge about advance directives and rules about your health information (medical record) we have created a fun little quiz. The answers are “True or False,” so you will have at least a 50% chance of getting a correct answer even if you are guessing. The answers and a brief explanation of why it is the correct answer follow the quiz. Good luck!
1. True or False
If my living will states “no resuscitation,” I should never be put on a ventilator – a machine to breathe for me.
2. True or False
With a healthcare power-of-attorney I can designate who I want making medical decisions for me if I am unable to make them myself.
3. True or False
HIPAA refers to people who are overweight, especially around the middle.
4. True or False
Once I sign a healthcare power-of-attorney, I can no longer make my own healthcare decisions.
5. True or False
If I have a living will, I do not need a healthcare power-of-attorney.
6. True or False
HIPAA protects your health information from disclosure without your permission.
7. True or False
With some restrictions on pregnant women, as long as long as I have use of my mental faculties, I have the right to limit or refuse medical treatments.
8. True or False
I am only allowed to name a family member as my “agent” in a healthcare power-of-attorney.
9. True or False
It is wise to name the same person or persons as your “surrogate” in a living will and as your “agent” in a healthcare power-of-attorney.
10. True or False
It is good to have a living will and healthcare power of attorney, but it is even better to discuss your wishes, as expressed in these documents, with the person or persons you have designated in these documents to act on your behalf.
Here are the answers:
1. False – Before a living will becomes effective, a physician must certify that you are either in a state of permanent unconsciousness or terminally ill. Until that determination is made, medical facilities are obligated to do everything possible to preserve your life, unless there is a physician order limiting your care. (see # 7)
2. True – One of the major purposes of a healthcare power-of-attorney is to establish who you want making decisions for you.
3. False – HIPAA stands for the Health Information Portability and Accountability Act. This act imposes strict penalties for the disclosure of your medical information without your permission to people who are not involved in your medical care and, consequently, do not have a “need to know.”
4. False – Unless you are mentally incapacitated due to medications or disease, you have the right to make your own decisions. Your power-of-attorney agent is your back-up for any time you are mentally incapacitated.
5. False – These documents have different purposes. The living will focuses on end of life care, while the healthcare power-of-attorney takes care of issues any time you are mentally incapacitated and require medical care.
6. True – (see the explanation in #3)
7. True – This is how people who do not meet the criteria for their living will to be in effect can avoid resuscitation in a medical facility. They simply have the physician write a DNR (Do Not Resuscitate) order in compliance with the facility’s policies.
8. False – You can name anyone of legal age as your agent.
9. True – If your living will and healthcare power-of-attorney are separate documents, it avoids any confusion over who is to make decisions if both documents name the same person or persons.
10. True – Even when you have put your wishes in black and white, it can often be hard for you agent to make decisions about ending life support. If you talk with your agent about your goals for treatment, it reinforces what you put on paper and, therefore, makes it easier for your agent to act on your behalf.
We hope you had fun with this quiz, and perhaps learned one or two things about advance directives and health information. Here is our scoring guide for the quiz:
8 – 10 correct – You know as much or more about advance directives as most health professionals.
5 – 7 correct – You demonstrate that no one knows everything and there is always more to learn.
0 – 4 correct – You are ready to soak up all this new information.
John W. Reese, M. S., CDP
Elder Care Coordinator