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Questions to discuss with a health care surrogate

We frequently stress that having a simple will does not help loved ones until after you pass away. In the days, weeks or years that you might be unable to make decisions, you need to have proper documents in place to avoid the need for a guardianship.

In completing Colorado advance medical directives – Medical Durable Power of Attorney and a Living Will – that will go into your estate plan, you may not quite be ready for certain decisions and conversations. In our last post, however, we explained that hope is not a plan (and a spouse or child will not know your wishes if you never discussed them).

In Being Mortal, physician Atul Gawande offers some questions that can start open up dialogue. “Breakpoint discussions” are how Swedish doctors refer the conversations needed to identify when to pivot from fighting a disease to fighting for things that matter – continuing to teach piano lessons, spend time with family or eat chocolate ice cream.

Some of these questions to ask after a difficult diagnosis are:

  • What concerns do you have about what lies ahead?
  • Are there trade-offs you are willing to make?
  • How do you want to spend your time if your health worsens?
  • Who should make decisions if you cannot?

An example from the book

The book provides many good stories, but this one sticks out. Even a palliative care specialist found it difficult to sit down with her father to discuss his end-of-life wishes. He had a mass growing in his neck. A neurosurgeon estimated surgery carried a 20 percent chance of leaving him a quadriplegia. Without surgery, he was bound to become a quadriplegic.

The night before the surgery, his daughter also his health care proxy, realized she did not know what he would really want. She turned her car around and asked. She learned her father was willing to go through a lot of pain if he still had the chance to eat chocolate ice cream and watch football.

When complications happened during the surgery and the neurosurgeon asked if they should continue with the surgery. She had one question: if the procedure is successful, will my father be able to eat ice cream and watch football. When the physician answered yes, she asked that they proceed.

Get the proper legal documents in place. In addition, have a conversation with your named decision maker to equip this person with the tools they will need to make difficult decisions on your behalf.

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