WHAT OTHER DOCUMENTS MAKE CHOICES ABOUT YOUR HEALTH CARE?

Living Wills and Health Care Power of Attorney forms are two common health care directives.    Here are some other health care directives you should know about:

• Do Not Resuscitate (DNR)
• Health Information Privacy and Portability Act (HIPPA)
• In Case of Emergency (ICE)

Q. Why do you need a DNR?

A. A Do Not Resuscitate (DNR) order is a request not to have cardiopulmonary resuscitation (CPR) if your heart stops or if you stop breathing.   Unless paramedics or other emergency staff are given other instructions, paramedics and hospital staff will try to resuscitate a patient whose heart has stopped or who has stopped breathing.

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Q. Why do you need to complete a living will and a DNR?

A. The directions in your living will are only followed when your doctor believes you are in a terminal state and will not recover from your illness or injury.   The directions in your DNR are effective the moment you sign them and do not require any type of medical condition to be present for the DNR to be effective.

Elderly people sometimes want a DNR if they suffer from chronic illness and are concerned that their quality of life will suffer if they require resuscitation.

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Q. What happens if the paramedics do not know you have completed a DNR?

A. If the paramedics or other medical personnel cannot locate your DNR, they will make an effort to save your life.

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Q. How can you help the paramedics make the right treatment choices.

A. You can help the paramedics in several ways.

• Participate in the Vial of Life program, a nationwide effort to assist emergency personnel administer proper medical treatment for you when you can’t speak for yourself.
  • A  vial of life sticker is placed on your door.  This sticker tells the paramedic to look for your DNR and other medical information in a vial placed in your refrigerator.
• Some people recommend storing the DNR in the freezer in a blue bag, as paramedics are trained to look in the freezer for DNR documents stored in a blue bag.
• Some states authorize the use of identification bracelets or tags as a way  to notify medical personnel that you have signed a DNR.

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Q. What is HIPPA?

A. HIPPA is the acronym for the Health Insurance Portability and Accountability Act passed in 2003.  In an effort to protect our privacy, HIPPA restricts the freedom of medical care providers to share medical information about you without your consent.

The provisions of HIPPA give you the right to view information contained in your medical records and to designate other persons with whom your medical information may be shared.

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Q. What if you have not completed a HIPPA form giving someone the right to view our medical records?

A. Without a written authorization from you, medical professionals and medical facilities fact stiff penalties for violating HIPPA.

Without advanced authorization by you, your health care agent, spouse, family and others will not be able to access your medical records to make an informed decisions about the best plan of care for you.

FACT.  HIPPA and adult children

If an adult has a child attending college, they should consider having the child sign a HIPPA form giving their parent the right to access their medical records.   Otherwise, if the student is in an accident, the parent may not have the right to iew the child’s medical records to make decisions about their care.

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Q. What is In Case of Emergency (ICE)?

A. If you are in a car accident or other accident requiring unexpected medical care, the physicians and emergency personnel must find a way to contact someone regarding your medical emergency.  Time is important.  Some medical procedures require authorization from a spouse or a health care agent before treatment can begin.  A shorthand process has been developed to facilitate this communication process, referred to as ICE.

Q. How does ICE work?

A.  ICE reflects the list of persons who you want contacted in case of an emergency.   This list of persons and their telephone numbers is stored on your cell phone.   The steps are as follows:

• Decide whom you want contacted in case of emergency
• Enter ICE as the contact name in your cell phone contact list
• Add the phone number of the person ou want called in case of emergency
• If you want to name more than one person, make an ICE1 and ICE2 entry in your contact list.

Paramedics and other emergency responders are trained to examine your cell phone and look under “ICE” for information on who to contact.

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Just when family and friends are dealing with the emotional grief associated with a death, a family member or friend will have to assume the responsibility for making tough decisions regarding the disposition of the body and planning funeral or memorial services.  The decisions are especially difficult if the death occurred unexpectedly or the subject of how to dispose of the body and where to bury the remains was never discussed with the decedent and/or the family prior to death.

However, this  stress can be reduced if your funeral is planned in advance and your wishes are put into writing and communicated to family and or friends.  That way, they will know what you want and will be able to carry out your plans rather that trying to figure out what you might have decided.

Whether you are planning a funeral in advance or the funeral is being planned after your death, you probably have a general idea about the kind of funeral to have.  This idea is probably influenced by religious and cultural practices, family traditions and cost. But like many others, all the things that would once have been included in a traditional funeral may no longer be wanted; preference might be to have a celebration of life rather than a mourning of death.  Perhaps the choice  might be for  a ceremony that is personalized and unique to the person being honored.  There might be an unlimited budget for the funeral or most of the assets may be left to family, friends or charities leaving very little to spend on someone’s last big event.

Regardless of the ideas you have, there are several things that should be considered.  The links below will help you to think through these things and will help you to make the necessary decisions.

• What needs to be done immediately after death?
• Who should be named as the funeral agent?
• What will happen to the body – whole body donation, organ and tissue donation, DNA sample?  What type of funeral will you choose?
• Where will the remains go?  How do you choose a funeral home, casket, grave marker, etc.?
• How can you pay for the funeral?
• What will the service be like?
• What is correct funeral etiquette?
• What are some tips that can save money?