25 Suggested Topics to Discuss With Your Health Care Agent

Before having your health care agent sign any forms, you should discuss your beliefs and wishes with him or her. When instructing your health care agent about your wishes in the event you become incapacitated and he/she needs to make health care decisions, we suggest you consider the following questions.  We suggest no particular answers, each person should answer these questions based on his/her own beliefs and convey those beliefs and wishes to his/her health care agent.  Any other wishes or desires that you feel your health care agent should know should also be given to him/her so that they can carry out his/her responsibilities as you would wish.

1. Do you think it is a good idea to sign a legal document that says what medical treatments you want and do not want when you are dying? (This is called a “living will”.)

2. Do you think you would want to have any of the following medical treatments performed on you?
  • kidney dialysis (used if your kidneys stop working)
  • cardiopulmonary resuscitation, also called CPR (used if your heart stops beating)
  • respirator (used if you are unable to breathe on your own)
  • artificial nutrition (used if you are unable to eat food)
  • artificial hydration (used if you are unable to drink fluids)

3. Do you want to donate parts of your body to someone else at the time of your death? (This is called organ donation,)

4. How would you describe you current health status? If you currently have any medical problems, how would you describe them?

5. If you have current medical problems, in what ways, if any, do they affect your ability to function?

6. How do you feel about your current health status?

7. If you have a doctor, do you like him or her? Why?

8. Do you think your doctor should make the final decision about any medical treatments you might need?

9. How important is independence and self-sufficiency in your life?

10. If your physical and mental abilities were decreased, how would that affect your attitude toward independence and self-sufficiency?

11. Do you wish to make any general comments about the value of independence and control in your life?

12. Do you expect that your friends, family, and/or others will support your decisions regarding medical treatment you may need now or in the future?

13. What will be important to you when you are dying (e.g., physical comfort, no pain, family members present, etc.)?

14. Where would you prefer to die?

15. What is your attitude toward death?

16. How do you feel about the use of life-sustaining measures in the face of terminal illness?

17. How do you feel about the use of life-sustaining measures in the face of permanent coma?

18. How do you feel about the use of life-sustaining measures in the face of irreversible chronic illness (e.g., Alzheimer’s disease)?

19. Do you wish to make any general comments about your attitude toward illness, dying, and death?

20. What is your religious background?

21. How do your religious beliefs affect your attitude toward serious or terminal illness?

22. Does your attitude toward death find support in your religion?

23. How does your faith community, church, or synagogue view the role of prayer or religious sacraments in an illness?

24. Do you wish to make any general comments about your religious background and beliefs?

25. What else do you feel is important for your agent to know?

If, over time, your beliefs in any area change, you should inform your health care agent.  It is also wise to inform your health care agent of the status of your health when there are changes such as new diagnoses.  In the event you are informed of a terminal illness, this, as well as the ramifications of it, should be discussed with him or her.  How well your health care agent performs depends on how well you have prepared him/her.

Reprinted from Center for Public Representation, Madison, WI.

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