Saturday, August 3, 2013

Planning for the worst

As I have said before, I work in a hospital, in ICU settings. I see a lot of unexpected accidents that result in horrible upheaval for families. Daily. This is a topic that is near to my heart because I deal with these issues on a regular basis. I'm addressing this toward pilot wives, but really it can be applied to anyone.

Disclaimer- I work in Florida and am most familiar with the laws here, some may vary by state.

Contact- What if you went into labor and delivered your baby at 28 weeks? If your toddler fell off your dining room table, hit his head and needed emergent neurosurgery due to a bleed? If you had a car accident and had to be hospitalized? If your pilot's parent had a stroke? And your pilot was on a 6 hour flight, or out of the country where you couldn't reach him easily. Do you know how to really reach your pilot through his company? Not a vague idea, but how to really do it? Is the number to call saved in your phone and not buried underneath toddler art and wedding invitations on your fridge? If the worst happens, are you going to have the time and presence of mind to search out how to reach him? Likely you won't get any help by just calling the customer service number with your pilot. Sit down and really clarify how to reach him and how to get his company to work on how to get him back to you even before you've been able to notify him. What number specifically? Who does that go to? Is it 24 hour? Will you be on hold for 30 minutes before someone picks up? It is easier to be prepared for the worst and hope it never happens.

Decision making- Are you listed with your pilot's company as his emergency contact? If you are married and something happens to him, you will automatically be tapped as his primary medical decision maker if he is unable to make them. If you are not married, no matter how long you have been together, you will not be allowed to make medical decisions. Even if you live on a different coast from the rest of his family. In Florida, alternate decision making follows a set list- spouse, living parents, majority of adult living children, majority of adult living siblings, other blood relative, interested friend. If you are not married and show up at a hospital, expect to provide the phone number of a next of kin. I have had to track down next of kin by rummaging through people's wallets, mail brought in by friends, and calling doctor offices and apartment buildings out of state.Who would be the decision maker for your parents or his? If there are siblings, are they all on the same page or would one want to prolong life at all costs while the others might not? Parents can also nominate specific children to make their health care decisions using the method listed next.

Alternates- If you are not married and your pilot would like you to make decisions (or him for you) the way to get around the set list is to nominate a Health Care Surrogate. This is a notarized document that allows you to make medical decisions on a person's behalf. But it must be done ahead of need. Once a person can't make medical decisions, they can't nominate a surrogate. This forms can be found online or at office supply stores. These forms are different from Power of Attorney forms. POA is limited to financial decision making unless medical is specifically mentioned. Health Care Surrogate is limited to medical decisions. Keep the form safe but accessible because hospitals will ask to see it if you ever are in a position to make decisions.

Health Choices- If you were placed in a position to make decisions on someone's behalf, do you know what they want? If your pilot had a head injury that left him alive but ventilator dependent would he want to live that way? Would he want a feeding tube if he couldn't eat? A great document to discuss decisions and record information is the Five Wishes document, usually put out by hospice agencies, doctor offices or hospitals. It is accepted in most states and is very comprehensive. Print a copy of the document or contact your local hospice agency to obtain a print copy, completed it and place it in a safe place.

Now, what I've asked seems fairly easy- track down a phone number and complete a few forms and get them notarized. It really is that easy. It can make life so much simpler for you, parents, single friends and siblings, anyone really. But it is so difficult to follow through on. Let me share the story of my parents...

While I happily reside near the shores of the Atlantic, my parents are mountain people and live in the Sierra Nevada mountains in Northern California. They are both now in their 70's. They are healthy, but spend the winter dealing with ice, snow and storms. Let's walk through what would happen if they both happened to slip and fall on the ice in the grocery store parking lot and be knocked unconscious. They would be taken to the local hospital and I would probably not be notified. Because they don't carry my number anywhere. The police would visit the address their car is registered to and possibly find a neighbor. Who likely knows they have a single child, a daughter in Florida, but can't provide any further information. Eventually, if I ever was tracked down, I would have to make my way to California to take care of them. I would have to break into their house because I don't have a key, nor do I have any neighbor's phone numbers. According to my mother, the information for the lawyer who set up their trust is "maybe in a box in the garage somewhere". Being their only child I am the default decision maker for healthcare, but I have no idea what their financial arrangements are- they keep putting off telling me. So I would root through their garage looking for something to tell me what their wishes might be. Instead of being at the hospital with them. I would also have to root around the house looking for my mother's phone book to notify her side of the family because I have lost touch with them since I moved to Florida.

Even though I am a super advocate for health care planning, I realize how difficult it is to get people to follow through. I have pointed out the missing pieces of my parents planning and provided them with multiple copies of Five Wishes on multiple occasions but they still have a "it won't happen to me" attitude. So I do the best I can. I encourage everyone to follow through with health care planning for themselves and their loved ones. Do it early, review it occasionally and have peace of mind that things will be done to your wishes.

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