29 Jul Ask Alice August 2020

Dear Alice,

With help from Taking Steps Brattleboro, I have recently completed and registered a Vermont “Short Form” advance directive. I am so relieved, and my children, who are in their late twenties and early thirties, are so grateful that we have had the “Advance Care Planning (ACP) conversation.” So I’m thinking maybe this would be a good time for me to suggest that it is not too early for them to begin their own advance care planning process. What do you think? They may balk at having extended discussions and getting into specific details, though. Is there an even shorter form that you can use to introduce them to the advance care planning process, which they can then build on later?

Thanks, Loving (though pushy) Mom

Dear Loving Mom,

Suggesting that your adult children start thinking about advance care planning is a great idea, and I love your question about a relatively short and easy introduction to the process. Lots of young adults (up to thirty-five years or so) realize they ought to have someone who can speak for them if they have a sudden accident or illness – someone who understands their general feelings and values relating to health care. But for various reasons, they don’t want to get into an extended conversation about specific situations and treatments yet, and they don’t want to document their wishes with the same degree of detail that they will want as they age.

Fortunately, we do have a shorter form called a Vermont “Appointment of a Health Care Agent,” which includes the appointment of an agent and back-up agent, as well as an open area for general comments about health care goals and wishes. These forms are executed and registered just like VT Short or Long Form Advance Directives. And then your children will not only have a clear agent if needed, but if their AD is registered, they will receive periodic reminders to make them think about whether it’s time to take the process further. Once you have something in place, it is definitely easier to change or expand upon it than it was to take that first step. (Note: If your children live outside Vermont, we can assist them/you with finding the right form to use.)

Thanks for writing, and stay well!

Best wishes, Alice

*****

Dear Alice,

I have several family members and friends who could be my health care agent. How should I decide? If I’m married, should it probably be my spouse?

Regards, Uncertain

Dear Uncertain,

How fortunate you are to have several choices for your agent!

There are no “rules” about who your agent should be (other than they must be 18), but there are some characteristics of potential agents you should definitely consider. Are they willing and able to discuss and understand your healthcare values and wishes now? If the time comes for them to make a decision, can you trust them to apply your values and wishes to the situation and make the decision you would probably want, even if their own values and wishes are different from yours? Would they be okay with asking tough questions of doctors and other busy healthcare providers, and would they ask for clarification if they do not understand? Is their emotional connection to you so strong that they would have a hard time making tough decisions on your behalf?

It follows from these considerations that your spouse or closest family member may or may not be a good choice. You will know best, and this is one of the important topics you can talk about with a Taking Steps Brattleboro facilitator. Whoever you choose, you will want to make sure your spouse and other loved ones are aware of your choice of agent, as well as your values and wishes, to minimize any family strife and maximize your chances of getting the care you would choose.

Thanks, and take care.

Best wishes, Alice

As always, please contact Don Freeman, Taking Steps Brattleboro Coordinator, 802-257-0775, ext. 101, or don.freeman@brattleborohospice.org, for information about Advance Care Planning.

Till next month, folks. Please send your questions to Alice via info@brattleborohospice.org.