A Guide to Documents – By Leslie Mantrone, LMSW
Life is unpredictable, and as we age, physical and cognitive frailty can combine with life’s surprises resulting in unforeseen challenges. While we cannot plan for all events, there are a list of documents that all adults, especially older adults, should complete so that their wishes will be known and so trusted individuals will be identified who will ensure that an older adults wishes are followed. These forms are known as “Advanced Directives.”
Health Care Proxy – A Health Care Proxy is a form that grants a trusted person the right to make health decisions on your behalf should you be unable to make your wishes known (such as dementia, being unconscious, etc.) It is good practice to name someone who lives near to you as well as to name an alternate health care proxy in case the primary person is unreachable or is unable to make decisions because of their own health issues. In New York State, there is a simple form for you to sign which must be witnessed by two people. Here is a link to the form: https://www.health.ny.gov/publications/1430.pdf
Living Will – Most people are familiar with wills – they explain how to disperse your money and belongings after you die. A Living Will, however, specifies to your Health Care Proxy and doctors your wishes regarding procedures relating to your medical care. While New York State does not mandate the use of a specific document to indicate your medical care wishes, there are some forms that are widely used:
MOLST Form (Medical Orders for Life Sustaining Treatment) – This form is one you fill out with your doctor so they will know what to do if specific things occur (such as if your heart stops, if you cannot breathe on your own, if you would like to donate your organs when you die and which ones, etc.) What you indicate on this form will be followed by medical or emergency service professionals wherever you may be, such as in a hospital, a nursing home or at home. Display it in a visible location once signed. Here is a link to the MOLST Form: https://www.health.ny.gov/forms/doh-5003.pdf
Five Wishes – Although this form does not hold the weight of law in New York State, it will provide your Health Care Proxy with clarity about your preferences for your health care under a variety of circumstances. The form was created to assist individuals to have important conversations with their loved ones about health care and end-of-life preferences. The Five Wishes website has an excellent guide to walk you through these important discussions: www.fivewishes.org
Do Not Resuscitate Order (DNR) – Medical professionals are charged with prolonging life. That means if your heart stops or if you stop breathing, they will do everything possible to restart your heart and your breathing. Some people, such as people of advanced age or those with certain medical conditions, may wish to specify to their Health Care Proxy or medical professionals circumstances under which they prefer natural death. The MOLST Form discussed above provides a section under which you can specify your wishes regarding life prolonging treatments. However, if you are living at home in the community and have not filled out a MOLST Form with your doctor (and don’t intent to), you can indicate to medical professionals (doctors and emergency service personnel) your preferences by having your doctor fill out this simple form called the NonHospital Order Not to Resuscitate (DNR). Here is the link to that form: https://www.health.ny.gov/forms/doh-3474.pdf Once completed, display this form in an easily visible location and tell your Health Care Proxy where it is so they can inform emergency service personnel in the event of an emergency.
Here is an excellent publication from the NYS Attorney General which provides excellent guidance about Advanced Directives: www.Ag.ny.gov/sites/default/files/advancedirectives.pdf