Posted on 29 Dec, 2022

Few people wake up in the morning and say, “Today’s the day I’m going to fill out a Medical Durable Power of Attorney (MDPOA) document!”

But if more people did so, the world would be a better place, according to Dr. Jeanie Youngwerth, a physician who specializes in Hospice and Palliative Medicine, and Internal Medicine at the UCHealth University of Colorado Hospital in Aurora.

“I see this as a gift to yourself as well as to your loved ones,” Youngwerth said. “It’s really the best way to protect yourself, your loved ones, and to make sure your voice is always heard.”

“Advance care planning helps you think about what matters most to you, and helps you to communicate that to your loved ones as well as your health care providers,” she said.

With a MDPOA document, patients appoint an “agent” to make decisions about life-prolonging care, treatment, services and procedures for them if they are unable to make such decisions for themselves.

In Colorado, an agent can be anyone age 18 or older. Ideally the person should be a close, easily reachable family member or friend who can be trusted to relay your wishes to a medical team if you become incapacitated by an illness or accident.

Youthwerth has had an agent in place since she became a UCHealth physician in 2004.

“This person should be able to assure your health care providers that they’re willing to take on that role,” she said. “The reason I say that is because that role can be stressful and hard. Sometimes, it can feel like an extra job.”

In Colorado, the consequences of not designating an agent can cause big problems if you become incapacitated. That’s because state law requires your health care providers to go through the time-consuming process of contacting your family and friends to find someone willing to serve as a de facto agent, or “medical practice decision maker.”

“This can cause delays in your care,” Youngwerth said. “It also can cause more distress to everybody, lead to family squabbles, and even complicate the grief that people go through when somebody has an illness.”

By appointing an agent or agents (Colorado law allows you to select one or two alternates), you are more likely to receive the care you want and experience a higher quality of life at the end of life.

Your loved ones also benefit. Research shows that they experience lower levels of stress and grief if they have participated in important conversations and advance care planning.

If you spend a significant amount of time each year outside of Colorado, consider filing a MDPOA document in additional states. “Colorado is really good at respecting other states’ documents,” Youngwerth said.

Many people mistakenly believe they need to pay high fees to have an attorney fill out a MDPOA document. Not so. You can do this for free through UCHealth or other avenues. You also can amend the document or designate a different agent whenever you want.

At UCHealth, getting more people to sign up for a MDPOA document is a top priority. A recent initiative led by the Oncology Nurse Navigators, for instance, led to a 10% increase in completed MDPOA documents in just two months among cancer patients.

Nurse Navigator Jane Jachowicz met a newly diagnosed breast cancer patient during a Telehealth visit, and instantly they bonded. Thanks to a 3-D mammogram, the patient’s cancer was discovered and treated early. Jachowicz said that encouraging patients to complete the MDPOA is just another way to help patients.

“As an oncology nurse navigator, it is important to be a strong advocate for each patient,” Jachowicz said. “This includes current and future needs.

“As a nurse who has chosen to work in the field of oncology, we are often faced with difficult conversations. For me, MDPOA is an empowering discussion. It can be tricky as to the timing of the conversation, but I’ve found most patients lately are not afraid of this topic since the arrival of COVID-19. The unexpected health events for many over the last 2-3 years have proven that discussions/documentation done today can provide peace for tomorrow,” Jachowicz said.

After talking with Jachowicz about the MDPOA document, the patient shared her passion for completing the document.

“Now is the time to decide what you want and who you want to carry out your wishes. No one knows if or when a situation might arise where you are unable to covey what you want,’’ the patient said. “The MDPOA document provides contact information for medical professionals to contact your agent(s) if you are unable to respond.”

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