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How Advance Care Planning Works in Real Life

Updated: Oct 6, 2022

Having an older brother with a mental illness drove home the need for advance care planning for Angela. Diagnosed with schizophrenia in his early 20s, Angela’s brother, Michael, needed in-patient psychiatric care a few times a year. He also suffered from other physical illnesses including diabetes and COPD.

When Angela moved her mother and brother from South Carolina to Tennessee in 2007 and made arrangements for Michael to live in a group home in Lebanon, Angela asked Takacs McGinnis to draft a simple one-page Healthcare Power of Attorney/Advance Directive that named Angela as Michael’s Healthcare Agent, gave her the ability to admit him to the hospital for treatment when needed and to make other decisions about his care, and spelled out the types of medical intervention Michael wanted in various scenarios.

Once the document was complete, Angela took copies to Michael’s group home. She also asked each of Michael’s health care providers to add the document to his chart. “When you’re responsible for the care of a loved one, you never know when the next crisis will happen,” said Angela. “Knowing that all of Michael’s doctors had his Healthcare Power of Attorney/Advance Directive gave me one less thing to worry about.”

Planning for emergency trips to the hospital added another layer of stress to the situation. “When Michael fell and broke his leg, the group home sent his Healthcare Power of Attorney/Advance Directive with him in the ambulance,” remembers Angela, who carried a hard copy of the document in her car’s glove box and had a digital copy accessible from the home screen on her phone. “It’s so important to have the form. If you or the doctors can’t find the Power of Attorney, they won’t speak with you. They can’t even tell you whether your loved one is in the hospital.” Having a Healthcare Power of Attorney is even more important in situations where several family members may be on the scene in a hospital, each claiming to be the decision maker. When more than one person claims to be the decider, the Healthcare Power of Attorney is what the doctors rely on to determine who the decision maker will be.

Angela exercised her decision-making authority to manage Michael’s care during several hospital admissions that followed. When Michael fell into a diabetic coma in 2015 and was rushed to a Nashville area hospital, Angela was able to email the Healthcare Power of Attorney/Advance Directive from her phone to the admissions representative.

Michael spent a week in a local hospital’s critical care unit. One morning Angela walked into Michael’s room to discover that he had been put on a ventilator because he had suffered irreversible brain damage and was unlikely to survive without life support. After discussing the prognosis with doctors, Angela and her mother decided to remove Michael from life support. “Although it was one of the hardest things I’ve ever had to do, I felt peace because I’d had the discussion with Michael and I knew that he didn’t want to be kept alive by artificial means,” said Angela. “You draft these documents knowing that someday you’ll need to use them and then all of the sudden that someday is here and the doctors are looking at you to decide whether the person lives or dies.”

Though few people look forward to conversations about illness, injury or death, those who forge ahead often feel a sense of relief. “Creating the Healthcare Power of Attorney for Michael opened the door to the discussion about his end-of-life preferences,” said Angela. “This was a gift to us both. I was able to be an advocate for Michael when it mattered most, and he was able to have a measure of control over his care at the end of life. I am so incredibly grateful for that.”

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