Working in the Care Management system for many years, time and time again I discovered the value of discussing End-of-Life Wishes and the importance of having a Power of Attorney in place.
The most challenging aspect of my work was when families thought that they had the right to make decisions for their loved ones when, in fact, they didn’t, not without a Power of Attorney in place.
A Power of Attorney (POA) is a legal document in which you (the donor) appoint a person to act on your behalf should you become incapacitated and unable to make decisions for yourself. This gives you more control of your life. The process is marginally different depending on where you live in the UK.
The importance of having a Power of Attorney in place
Scope of Authority
The scope of authority in a POA outlines the extent of power granted to the attorney. It can be:
- General: Allows the attorney to handle a wide range of the donor’s affairs.
- Specific: Limits the attorney to certain actions, such as selling a property or managing particular accounts. The scope must be clearly defined to avoid ambiguity and ensure that the attorney acts within the boundaries set by the donor.
Type of POA
- Health and Welfare POA: This type of POA enables the attorney to make decisions about the donor’s personal healthcare and welfare, including medical treatment, living arrangements, and daily care. It can only be used when the donor lacks the capacity to make these decisions themselves.
- Property and Financial Affairs POA: This grants the attorney authority to manage the donor’s financial matters, such as banking, paying bills, and handling investments. Unlike the Health and Welfare POA, it can be used with the donor’s consent as soon as it’s registered.
Instructions and Preferences
These directives included in the POA guide the attorney’s decisions.
- Instructions: Legally binding directives that the attorney must follow. They are explicit commands using words like ‘must’ and ‘shall’.
- Preferences: Non-binding wishes expressing how the donor wants the attorney to act. They use language like ‘prefer’ or ‘would like’ and are intended to guide the attorney. These elements are crucial for creating a POA that accurately reflects the donor’s intentions and provides clear guidance to the attorney. A copy of the POA should be registered with your GP. When a person loses mental capacity, they can no longer create a POA. In such a case, a guardianship or intervention order might be necessary before anyone can act on their behalf. This can be long, costly and emotionally draining.
What should you be considering?
Making decisions about health and on someone’s behalf can be challenging. Your beliefs may differ from those of your nominated person. An Advanced Directive / Advanced Decision will help ease that burden.
Advanced Directive / Advance Decision
An Advanced Directive (Scotland) is a written statement in which an individual specifies their wishes to refuse specific medical treatments in the future, particularly if they become unable to make or communicate decisions due to a lack of mental capacity. It ensures that healthcare providers and loved ones know the individual’s preferences regarding treatments they do not want to receive. In England and Wales, this is called Advanced Decision.
This should be kept where it is easily accessible to those who might need to refer to it, such as a family member, a lawyer, or a healthcare provider. Remember to inform family members or friends about its existence and location. Register it with your GP and hospital records to ensure it’s considered during medical care or emergencies.
You can go online to find templates for an Advanced Directive.
DNACPR
A Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) document is a medical order indicating that cardiopulmonary resuscitation (CPR) should not be performed in the event of a patient’s cardiac or respiratory arrest.
It is created to prevent unnecessary suffering by avoiding CPR that is unlikely to be successful, or that may cause more harm than benefit, especially in patients with severe underlying health conditions or those who are at the end of their life.
A DNACPR document is created after discussing it with the patient and their healthcare team. The decision is based on the patient’s health status, preferences, and the clinical judgment of healthcare professionals.
If the patient cannot participate, healthcare professionals will decide involving family or caregivers.
The document is then recorded on a special form, which is kept with the patient’s medical records to ensure that the patient’s wishes are respected in an emergency. The patient should keep a copy at home so that if paramedics are called, they can be shown the document so that they do not start CPR.
It’s important to note that a DNACPR order only relates to CPR and does not affect other treatments or care that the patient may receive.
After the Last Breath
It is more than saying, “I want to be buried, or I want to be cremated”. Have you considered all the options open to you after exhaling your last breath?
Only three things are required following a death:
1. The death must be registered.
2. The body must be disposed of, i.e. cremated or buried. NB, in very specific circumstances, a body may be “buried” at sea. This is exceedingly complex to organise and has particular requirements.
3. When transporting a body, it must be covered so as not to cause the general public distress.
Dead Good Conversations
Consider having an open and honest discussion with your loved ones about your funeral wishes.
Whether you prefer a traditional funeral service, a celebration of life, or something unique, you need to provide clarity and guidance for those closest to you when the time comes
Document your wishes in writing, and you can add them to a legal document like a will or advance directive, ensuring your plans are known and respected.
Remember, talking about end-of-life plans is a way to show your love and consideration for your family. You can comfort and reassure your loved ones by sharing your wishes openly and honestly.
It truly is the best gift you can leave behind.
Never doubt the importance of having a Power of Attorney in place. Let me help guide you to create your unique and personal funeral pan and service… Contact me Isabel Addison.