Making a Decision About Your Care


Often at some point in a person's healthcare, serious discussions must occur about what level of life-sustaining care the patient wants or how care should be provided in the event the patient is no longer able to make decisions for him or herself.

Such decisions are profoundly difficult for patients and families. But if the issue is not resolved, it often becomes difficult for caregivers who can become caught between their professional responsibilities and the competing opinions within a patient's family.

In the commonwealth, Honoring Choices Massachusetts is the group that helps people ensure that their healthcare choices are understood and honored throughout their lives. Among the collaborating partners of Honoring Choices Massachusetts is MHA; the Massachusetts Medical Orders for Life-Sustaining Treatment (MOLST), which MHA has supported; as well as the Hospice & Palliative Care Federation of Massachusetts, and the Massachusetts Council of Churches.

There are many components to creating a good healthcare decision plan. For example, it's important to sign a Healthcare Proxy, which is the legal document though which you appoint a trusted friend or relative known as a Healthcare Agent to make healthcare decisions for you if you are not able to make effective decisions for yourself. Concurrently, it's important to draw up a Personal Directive, which is a personal document or statement in which you give your Healthcare Agent information and instructions about the kind of medical care you want in the future. The previous steps cover medical decisions, but it's also important to create a Durable Power of Attorney, which is a legal document in which you appoint a trusted person to manage and protect your financial matters if you aren't able to do so for yourself.

At the same time, people should fill out a MOLST form, which is a medical document that communicates your decisions about life-sustaining treatments to your care providers. It tells the care team that you and your doctor or care provider have discussed your current medical condition and the role of life-sustaining treatments, and that you made decisions about the treatments you want or do not want. Anyone involved in your care will follow the MOLST form.

Links to the forms and in-depth explanations of them, are available through the resource page of Honoring Choices Massachusetts. "Confronting a serious illness, or preparing for a time when we are unable to make decisions for ourselves, is difficult and a source of anxiety for many," said MHA's Noga. "But entering into such a difficult period without a plan about how we wish to be cared for multiplies the anxiety for families and for caregivers. It's important to make choices and that's why MHA is such a strong supporter of healthcare decisions."