Health Proxies and Living Wills

Health Proxies and Living Wills in a time of Coronavirus: Here’s everything you need to know…

The Covid-19 Pandemic has unfortunately created ripples that have altered the landscape when it comes to necessary healthcare documents. Do you have your living will or health proxy in place? If so, do these documents reflect the changes brought about by the newly discovered coronavirus? What else needs to be taken care of, altered, or updated?

These are important questions that every individual need to address because coronavirus is undoubtedly a serious health concern. It has continued to spread on a global scale, causing hundreds of thousands of deaths typically by attacking the lower respiratory tract and causing acute breathing difficulties. In addition, it is easily transmittable through airborne means which increases the risk of possible infection if specific protective measures are not adequately observed.

Involve your loved ones

According to WHO, the excellent news concerning coronavirus is that the majority of people will only experience mild symptoms from the disease, which means recovery without hospitalization. However, the following groups are at high risk of serious coronavirus complications:

Those with underlying health conditions such as diabetes, heart and lung problems, cancer, or any illness stemming from a compromised immune system.

People over the age of 65

Residents of nursing homes and care facilities

This does not mean other groups not mentioned are not susceptible to severe coronavirus effects, but such cases are rare. If someone close to you is at serious risk, then it is critically important that they make an effort to obtain valid health care documents.

Exercise calm practicality

As the death toll from the coronavirus continues to curve upwards, it is understandable to feel alarmed, helpless, or fearful. Many people have watched loved ones die from this viral infection which raises the question: Am I next? It can be tough to accept the situation, and yet above everything, the most important thing is to remain practical and level-headed.

This means a complete realization that coronavirus infection may very well be a likely event. Taking action to ensure proper documentation will increase your peace of mind since it gives you full assurance that the right medical decisions will be made in the worst-case scenario.

Update your documents to match the current environment

The worst thing that can happen is to discover at a critical moment that your documents are not valid or legally binding. To avoid this, it is essential to make sure that you and your loved ones (particularly the elderly and sick) have updated all living wills, healthcare proxies, and other vital documents. It is essential to look out for the following:

  • The age of all documents must be analyzed in case the fine print has become outdated and irrelevant. Documents should both be legally binding AND applicable.
  • The documents should embody all your wishes which may need to be updated in light of the current environment.
  • Consult with an attorney/lawyer or conduct your research to clarify exactly what needs to be amended in each document to reflect the coronavirus healthcare climate.
  • Furthermore, it is recommended to be fully aware of what each document entails; the definition as well as any general information. Thus, a brief explanation is provided for each document in this article.

Living will

Living wills are also known as advanced healthcare directives. They are legal documents which clearly state a patient’s instructions regarding their medical treatment. They become applicable when you are incapacitated due to ill health and are therefore unable to communicate or make decisions about your care. They are especially important as they declare your personal, preferred wishes which are honoured even when coronavirus is involved.

Healthcare Proxy

This document enables you to assign legal authority to another person or a designated agent who will be able to make sound medical decisions on your behalf if you are unable to exercise this function. This is an important document that must mirror any coronavirus-related health and legal requirements.

HIPPA release

The terms of this legal document are provided for in the Health and Insurance Portability and Accountability Act. It allows you to appoint an agent that will have access to your personal health information. This person will also be able to disclose such information to your healthcare providers where necessary. To protect your privacy and ensure easy access to your medical records, a HIPPA authorization form must correctly identify the appointed agent(s) as well as the information they are to access. This too is an important document that might need a few corrections because of the coronavirus pandemic.

DNR (Do not resuscitate)

In simple terms, a-do-not-resuscitate order is a legal document that explicitly states that you should not be revived through cardiopulmonary resuscitation if your heart stops working. Healthcare providers will be instructed to allow you a natural death. 

Power of Attorney and Will

These two documents are also essential, but they will only be looked at briefly in this article.

A Power Of Attorney (PoA) allows you, the Principal to authorize an agent to act on your behalf regarding financial and business-related matters. The agent named in a PoA acts in a different capacity to the agent named in HIPPA releases or Health Proxies.

A Will is a legal document that only becomes applicable after your death. It lays down your specific wishes about the distribution of your private property and care of minor children. A Will is a dispositive document in that its primary function is to facilitate the transfer of property after a person dies. A living revocable trust is another dispositive document, but in contrast, it is immediately effective after it’s made. It is possible to have both a revocable trust and a Will.

Reassess the instructions contained in all your healthcare documents

This step requires you to go over your living will, health proxy, HIPPA release, and other related legal documents to ensure they apply to the current times of coronavirus. This applies to all adults, but the elderly and those with underlying medical problems are further strongly encouraged to review these documents. What should you look out for?

All documents should have your correct signature to validate the wishes laid out in each form. 

Where a document calls for the naming of an agent, the agent should be identified in full and should be a willing and capable party in the fulfilment of your wishes. In the event that the named agent is unable to fulfil their obligations when the time comes at least two more successors should be appointed.

If your document has aged, make sure the information it contains is still applicable. This includes any addresses and the availability of named agents.

Online storage of these documents in a suitable form (usually PDF) is recommended for easy access and safe storage. However, it is also wise to keep printed copies. These can easily be handed over during a rushed hospitalization process.

These are common things you need to be aware of as you revise your documents. Additionally, the coronavirus pandemic dictates that more prompt and serious alterations are to be made to all documents associated with health care. It is critical that these specific changes be made and you are also advised to inform your loved ones of this issue as well as those who might be at risk.

Adapt your healthcare-related documents to the coronavirus situation

Should you be hospitalized, social distancing, quarantine, self-isolation, and lockdown measures that have been implemented in various areas may likely restrict the way traditional healthcare documents are used. This might mean that the agent designated in HIPPA releases and health proxies won’t be able to attend to their duties in person.

What then should you do? 

The only viable alternative is to authorize your agent to communicate on your behalf long-distance. Fortunately, there are many available platforms to do so, including mobile calls, video calls, Skype, texts, and emails. Instructions should be included that conclusively state that you have deemed it appropriate for your agent to act on your behalf in this way. Moreover, your healthcare providers should be assured that they will not be held accountable for accepting indirect communication or decisions from your agent should anything happen.

As you can see, the coronavirus has ushered in unprecedented situations that have not yet been addressed in many healthcare documents. It is important that your documents be modified to match the environmental and personal restrictions concerning coronavirus. If you are not sure how to make the right provisions, a convenient template has been included to give you an idea. The template can be inserted into your health proxy or HIPPA release after it has been approved by your attorney and when you are completely satisfied with the wording.

Template: Giving your agent authorization to communicate in alternative ways

“I do hereby grant my Agent full authorization to act on my behalf and communicate with my healthcare providers either in person or through other forms of communication that are direct or indirect and where my Agent may be absent from the scene. My Agent should be allowed to communicate using the telephone, mobile calls, emails, or any other way that my Agent can be contacted or availed. In addition to the above, I will not hold any of my healthcare providers and related personnel accountable should they accept decisions and communications made by my Agent in a remote manner. This clause exists solely to enable my Agent to act on my behalf by communicating with my medical providers or making decisions using such means as has been stated should the situation necessitate such methods.

Address Intubation Issues in your healthcare documents

The fine print in your healthcare documents should specifically address the matter of intubation. Why is this important? Coronavirus affects the respiratory tract and causes breathing difficulties. The treatment for this involves endotracheal intubation where a tube is inserted into the trachea through the mouth. Mechanical ventilation is then provided for by a ventilator or respirator. Reports have indicated that early intubation in coronavirus patients may prevent hypoxia (deficient levels of oxygen in body tissues).

You should never treat your healthcare documents the way most people treat the generic “terms and conditions” documents they come across in everyday use. Do not make the mistake of briefly glancing at the wording before allowing authorization. Most healthcare forms have been generalized and standardized, which means they may not even express your wishes at all. This is especially likely if you did not draft the document or if you simply downloaded the most appropriate form you could find online. In such cases, you may be shocked to discover you signed a document that forbids intubation to be carried out on you even in a life and death situation.

This means you will not be prioritized in any hospital where ventilators are in short supply. In some cases, some intentionally state in their documents that they do not want to be kept alive artificially. Yet they may be alluding to extremely severe medical complications where there is little hope of survival. But, a person can recover from coronavirus if intubation is quickly administered. These people will undoubtedly want to be intubated, and yet their documents state otherwise!

It is critical to go through the intubation terms in your documents with a fine-tooth comb to make the necessary revisions. Your healthcare documents should expressly state your wishes regarding intubation and the coronavirus.

You may need your lawyer for this.

It may be difficult trying to navigate all the legalities involved with your healthcare documents. In such cases, your attorney is the best person to consult. Most attorneys are well versed on how state laws differ, and they will be able to guide you so you can ensure that your healthcare documents are valid and relevant in the state you reside in. Your lawyer can also assist with matters like witness signatures and notarizations and whether these can be made applicable through remote and electronic means.