Medical bills can pile up fast, especially if you end up in the hospital for an extended stay. In a worst-case scenario you could end up unconscious for an extended period, racking up tens if not hundreds of thousands of dollars in medical bills, causing you or your family undue hardships.
If you end up unconscious or otherwise incapacitated, your family and doctors may have to make some tough decisions for you—and they may be decisions you would not have made for yourself.
Fortunately, there is a way to make sure that your wishes are followed if you are ever in a situation where you are receiving medical care but unable to communicate your wishes. It’s called an advance healthcare directive.
What is an advance healthcare directive?
An advance healthcare directive, like insurance, is something that you should have in case things go wrong, but that you hope you will not need. It is like a health care power of attorney and a living will combined.
An advance healthcare directive allows you to set forward your end-of-life wishes if you are unconscious or otherwise unable to communicate. You can grant someone medical power of attorney in the document and also specify your preferences for a number of different decisions.
For instance, you can put forth your wishes as to:
- Organ donation
- Access to medical records for your decision-maker
- Medical care, such are medical tests, surgery, and medicine
- Pain management, including authorizing or refusing certain medications or procedures
- Preferred assisted living facility, nursing home, hospital, or hospice care
- If you want a DNR (do not resuscitate) order if your heart stops or you stop breathing
- Where you want to spend the last days of your life (home vs. hospital, for example)
- Religious rites or rituals before or after you die
- Any other issue related to your medical care
Why not leave it up to my family?
There are a number of reasons why you might not want to leave medical decisions up to your family and/or your doctor. Many people have strong feelings about not having their lives artificially prolonged if they are unlikely to regain consciousness, for example. But their families may be reluctant to let go, or may not be emotionally prepared to make a decision like taking you off life support.
Medical advances have made it possible both to keep someone who is unconscious alive longer in hopes of a recovery, as well as to determine if the brain activity indicates if the patient is likely to ever regain consciousness.
Some estimate that between 200,000-300,000 people are being kept alive in permanently vegetative, comatose states—yet studies show that a majority of the population believe that there are some states of living — such as 24/7 confinement to bed, unconsciousness, needing breathing support, and others — that they consider worse than death.
There have been cases of people miraculously regaining consciousness after years in a coma—and medical advances can play a part in determining if that is a likely outcome or not. Part of what you can specify in an advance healthcare directive is whether you would like life support removed if the prognosis is dim.
What is the cost?
Medical costs are unpredictable and vary widely between medical providers and health insurance providers. So the real cost per day or per year of being in a coma or vegetative state in a hospital, for example, is something you may only be able to find out when you get the bill. That said, there have been many cases where bills have reached into the hundreds of thousands of dollars, and a stay in the hospital can easily run $1,000-$2,000 or more per day.
Minimize the burden
Writing an advance healthcare directive is something that can be done when you make your will. It can save your family additional heartache and expense if you ever end up unable to make your own decisions about your care and unlikely to ever recover.