Ensuring You Have a Voice in Your Health Care


Recently, a friend’s mother was rushed to the emergency department of a Long Island hospital.  She had a high fever and was experiencing symptoms that the family felt were indicating she might test positive for the coronavirus.  As is the case in a growing number of filled-to-capacity hospitals, no one aside from the patient was permitted entry.  My friend was forced to leave his mother at the hospital, knowing that there was nothing he could do beyond going home to wait to hear more. 

The federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) was established to protect a patient’s personal and health information.  If health organizations do not adhere to HIPAA, they can face heavy fines.  This has led many hospitals to create strict protocols regarding releasing any information about patients.  My friend was only able to obtain minimal information regarding his mother.  Fortunately, she was released from the hospital the following day.  However, had her condition gotten progressively worse to the point of her incapacitation, without a health care proxy in place, her son may not have been included in decisions regarding her care. 

The way our healthcare system is being forced to function while dealing with the coronavirus pandemic is unlike anything we have experienced before.  Even some maternity units are making case-by-case assessments as to whether anyone other than the delivering mother can be present.  In American hospitals, we have always had the ability to be nearby, possibly in a waiting room, but available to speak up for our loved ones as an advocate.  A patient who is scared, sick and overwhelmed has been able to count on a family member or close friend in the room to help process new information and assist in making important decisions. 

Health care proxies have always been important.  A health care proxy is a legal document which allows you to appoint someone you trust to make health care decisions for you if you lose the ability to make decisions yourself.  Prior to the COVID-19 outbreak, a trusted person could generally be at your side in the hospital.  Hospital staff would confirm if they had your permission to speak about your health care with that person present.  All of that has changed.  Now more than ever, it is necessary to make prior arrangements that will allow medical personnel to speak with a designee of your choosing and to follow your wishes as closely as possible.    

Consider that your 19-year-old daughter home from college, or your elderly parent who is already dealing with a host of underlying medical conditions, could be rushed to the hospital.  You must leave them at the door. This is a frightening prospect, especially given the possibility that critical care services can be necessary to treat COVID-19, you will not be able to visit them in the hospital, and some patients will require an extended stay.  Even with a health care proxy, depending on hospital policy and HIPAA protocols, medical staff may or may not discuss their treatment or condition with you.  However, if a patient becomes unable to make decisions on their own, the health care proxy will come into effect. 

STEPS YOU CAN TAKE RIGHT NOW

  • Do you have a health care proxy?  If you do have a signed health care proxy, now would be a good time to review it.  Speak with your designees and go over your wishes for your health care should you become sick. 
  • What if you don’t have a health care proxy?  Any member of your household over age 18 should have a signed health care proxy.  There are standard health care proxies available to download by state.  New York’s form is available here:  https://health.ny.gov/publications/1430.pdf  We recommend that if you have any question as to how to complete the form, you should contact an estate attorney.  An estate attorney can also help you prepare powers of attorney to designate someone to handle your financial affairs if you are unable to do that.   
  • Make a list of your medications.  First responders advise having a typed list of all your medications, strengths and dosages available to provide in case of an emergency.  This list should include over-the-counter medications and nutritional supplements, such as vitamins.
  • Make a list of underlying medical conditions.  It can help medical providers to know if a patient is a diabetic, has high blood pressure, has cancer, allergies to medications, etc.  While your list of medications will give medical providers quick insight into what conditions you may be under treatment for, given the current high volume of patients and demands on hospital staff, any relevant information you make easily accessible can be a help, particularly since a family member will not be there to provide those answers.   

In uncertain times, the lack of control we have over our circumstances can be incredibly frustrating.  As we continue to deal with the COVID-19 crisis and the impact it has made on our lives, we are all looking for things we can do to find some stability.  Beyond staying informed, social distancing, quarantining and taking appropriate hygiene precautions, ensuring that our legal documents are in order can help us provide the best care possible for our loved ones.

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