Creating a personal health care plan

It begins with finding the right agent.

​Shirley SanSoucie and Dr. George Santos chat before an eye exam, one of many services offered at the health fair​. — Laura Hilliard

On Thursday afternoon, Sept. 28, the Tisbury Senior Center hosted a free health care planning workshop titled “Who’s Your Agent?,” in partnership with Hope Hospice, Hospice of Martha’s Vineyard, and Honoring Choices Massachusetts. A health care fair followed the event at the same location, with representatives from a number of local health care entities in attendance.

Although no one likes to consider losing his or her capacity to make decisions about health, it can happen in an instant. Naming a trusted person as a health care agent is a critical decision in having wishes followed when people cannot speak on their own behalf. In Massachusetts, five specific documents allow an individual to create a plan to support their wishes in such an event.

The “Who’s Your Agent?” workshop, based on the public education program by Honoring Choices Massachusetts, was presented by Ellen McCabe, RN, CHPN, and director of professional education for Hope Hospice. Using slides, video, and personal anecdotes, Ms. McCabe engaged participants in the process of creating a personal plan for meeting their health care wishes, starting by choosing a health care agent named in a health care proxy. She next discussed the personal directive, the only non-legally binding document of the five, which gives the agent and caregivers a road map for the types of care someone may or may not wish to receive.

The durable power of attorney names a financial decision maker, and Ms. McCabe suggested that this document be completed with the assistance of legal counsel. The MOLST (medical orders for life-sustaining treatment) and CC/DNR (comfort care/do not resuscitate) documents address end-of-life decisions, and it was suggested in the workshop that these be done with a health care provider who can give individual guidance. An attentive audience filled the room to capacity, and their questions and personal stories added to the discussion.

Ms. McCabe said creating a personal health plan is important at every age and stage of health, and although the cultural barriers to discussing health, illness, and death often make these topics uncomfortable, she stressed the importance of open dialogue in talking about our wishes with those we care about, because it decreases family stress when decisions need to be made. She quipped, “It’s not about the choices. It’s about the conversation. You can’t have your wishes come true if you don’t make a plan, and that plan should be about the life you live, not the death you want.”

Moving these conversations about health, illness, and end-of-life care out of the emergency department in the midst of a crisis and into people’s homes is how to begin a dialogue about our wishes for ourselves, our health, and the health of those we care about. Programs like “Who’s Your Agent?” educate community members about how to begin tough conversations and turn them into plans that support our health care values.

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