Guide for Family Advocacy

Phone call: Start by informing the family member the importance of being prepared for any medical decisions that will be needed in the future, and decide on a good time and place to meet. Ask them to bring any important documents with them for review.

Prepare: Organize your paperwork in a folder labeled with the persons name.  I highly suggest researching Portable Medical Orders (AKA POLST), general surgery consent, anesthesia consent, blood consent, and what to expect during and following a resuscitation (CPR) here's a link to some excellent information. Print and bring copies of these with you to the meeting. If not yourself, find out who the Medical Power of Attorney is, and inform them of the meeting.

Discussion: This is the tough part, but MUCH better to have this conversation in a comfortable setting and not in the hospital under duress. Be honest, and respect the family members decisions. Many times they are more concerned about YOU then themselves, let them know not to worry about others and to stay focused on what they want. To open I like to ask "What are your expectations for your future?" and allow them time to answer. Present your research on POLST and consents, like any contract let them read them carefully and answer any questions you can, if you don't know the answer write the question down so you can research it later. 

Topics to consider:

• POLST: Designed to give directions in regards to the use of CPR and other medical     interventions.  https://wsma.org/POLST
• What surgical procedures should not be done if unable to make their own decisions. In some cases patients with cognitive disorders or illness do not recover well from major surgery because they are incapable of following postoperative instructions (i.e. strict bedrest, use of mobility devices, non-weight bearing, physical therapy, etc.).
• Will they accept blood transfusions? Grafts/tissue/organs from donors?
• Are they an organ donor? 
• You'll want to get a list of their medical providers, insurance information, medications,  and health history.
• Is there a life insurance policy?
• Ask where important documents and passwords are kept in the home.
• Identify if there is already a plan in place for assisted living or long-term care, and if not discuss ideas.
• Schedule an appointment with their primary care provider to discuss and sign the POLST.

After the meeting and the paperwork is completed prepare several stapled copies, keep one for yourself and give the rest (minus the passwords) to your loved one. This gives them easy access to copies that they can bring to appointments, surgery, or emergencies. Also, post the POLST along with emergency contact numbers, allergies, current health conditions and medications on the refrigerator for paramedics to find easily.

This just an outline of how to prepare and have this conversation with a loved one, no matter what age! It's NEVER too early to have a plan, it is not permanent and can change as life events happen.

I find the following website very informative - compassion & choices