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Who Makes the Decisions When They Can’t?

September 18, 2011

One of the most difficult situations was when we reached the point where my parents were unable to make their own decisions.  It was easy to get caught up in the day to day management of the situation and forget where the disease will take over.   But not taking care of this issue could have led to major problems.

Shortly after Mom was diagnosed with Alzheimer’s, our family sat down and executed Durable Powers of Attorney for Health Care.  These documents provided that when the person signing them was unable to make decisions  the person they named (the Agent) was authorized to make those decisions.  It also means that the Agent can obtain all of the information necessary to make those decisions.   An Agent is responsible for making decisions as the individual would have made them, not as the Agent would make for themselves.

The process of completing these forms as a family led to numerous conversations with my parents about end of life medical care.  I learned what each of my parents would decide in various situations if they were unable to make the decisions for themselves. This was critical point since my job as Agent was to implement the decisions they had made.

During the remainder of Mom’s life, Dad was the one who made her decisions.   He also went to most of her medical appointments with her.  Occasionally, I went with her and, as long as she asked that I be in the room during exams, the doctor had no problem with talking in front of me.

Mom became septic after a relatively minor surgery.  She quickly began to fail and when her breathing became labored, the doctors offered to put her on a respirator to ease her breathing.  Since we had already talked about the various extraordinary measures that were available to keep Mom alive,  Dad and I needed only a brief conversation to confirm our decision.   Mom had been clear that she didn’t want to ever be on a respirator.   At this point, even though Dad was the Agent for Mom, I stepped forward and informed the doctors that we would not be providing any more medical care for Mom other than to keep her comfortable.  I know it was easier for Dad not to be the one to make this statement.

My siblings may not have made the same decision.  They still wanted to fight for her life.  If we had not had the Power of Attorney this would have been a very difficult and unpleasant situation.

I have been making all of Dad’s medical decisions for the last 6 years.  My siblings all recognize that I have the authority to make these decisions.  They will ask questions about decisions I make and give me their opinions but they accept what I decide.

Having these documents in place and knowing what decisions each of my parents would make has simplified my decisions.  It also gives me comfort to know that I am fulfilling their wishes as I make difficult end of life decisions.

One Comment leave one →
  1. September 27, 2011 9:22 am

    Thanks for your thoughts on this. We have this in place, thank goodness. It is a road we haven’t had to go down yet. I don’t think it will be long until we have to invoke these things as dad is not always making the best decisions for himself!

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