Health Care Directives–Don’t Leave Home Without Them?

Introduction
Health Care Directive Defined
Take It With You Option
Have a Friend Fax it to You
DNR Situation
Health Care Directive Digital Vaults
Email–Free Alternative
On Line Storage-Free Alternative
Card In Your Wallet

Dear Mr. Miller:

Introduction: Mary and Ted had always wanted to take a cruise around the world. The date had finally arrived, the ship was marvelous, they had stopped in some amazing places, and they were having a wonderful time. They were on their way back to the States and had stopped in Hawaii.

While out on an excursion, the bus they were in was hit broadside by another vehicle traveling at 60 MPH. There were a number of injuries. Mary had lapsed into a coma. They rushed her to the hospital. They asked Ted if he was authorized to make medical decisions for her. Of course he was; not only was he her husband but they had signed health care directives for each other just a year ago. The hospital asked for a copy; that copy was back on Ted’s desk in California!

This is a question I ponder all the time: Should I travel with a copy of my Health Care Directive?–About to Travel

Dear About to Travel:

Health Care Directive Defined: First, let’s make sure we agree on what we are discussing. A Health Care Directive, also called a Power of Attorney for Health Care or a Health Care Proxy, is a legal document appointing another (such as a spouse) to make health care decisions for the one signing the document if the signer is incapable of doing so. It is authorized by most states and has to meet certain legal standards. For example, in California, the document must either be notarized or witnessed by two witnesses.

Take It With You Option: Some articles I have read suggest taking it with you on all trips. Some go so far as suggesting that you keep a copy in your glove compartment in your car. Personally, I have never done either of these.

Bottom line: I hate carrying things. Why? Well, this gets a little Freudian. When I was 5, my Dad had a heart attack. He recovered but my Mom was always worried about him over-exerting himself. Couple that with the fact that he was a semi-pro photographer in the days of metal (i.e. heavy) cameras and guess who became the “camels” to carry the photographic stuff. Yep, my brother and myself. Think of a 5 year old, small to begin with, strapped from head to toe with photographic equipment.

I travel with enough paper work. All of those plane e-ticket receipts, the itinerary, the hotel confirmations, walking tour information, etc. On a one week trip I can have 30 or more pieces of paper; two week trip–just double it. And then I generally bring magazines to catch up on my reading material. Out of the country I have passports to worry about. With everything else that I bring, my carry-on bag in which this stuff is stored is loaded to the gill and heavy. What I don’t need is another 10 page document for myself and my wife. So I don’t bring it.

Have a Friend Fax it to You: Here’s my thinking: Even in Mary and Ted’s predicament, it would seem to me that Ted could call his daughter and have her go over to the house, get the document and fax it to the hospital. Anything the ER physicians need to do on an emergency basis they are going to do with or without formal consent from Ted, anyway. After all, what if Ted were also in a coma. Do you think they would just let Mary die because there is no one there with a health care directive?

Since I have never had a hospital ask me for an ink original when a family member has needed ER or other hospital services, I suspect copies are acceptable. But even if they needed the ink original, that’s what Fed Ex overnight delivery is for. And if Ted’s daughter doesn’t live in the same city, most people have next door neighbors, etc. So, in the vast majority of cases, I don’t see a problem with getting a copy to the hospital in a reasonably timely manner (assuming you know where the document is located).

DNR Situation: Now, you are probably thinking about what if Mary has a Do Not Resuscitate (DNR) order. If her health is so bad that she has a DNR order, then I think she is probably not traveling very much and certainly not very far. So I believe that this is, in almost all cases, a non issue.

Health Care Directive Digital Vaults: But, if you are still worried about being able to get that document into the hospital’s hands and the daughter or neighbor solution is not one you wish to rely upon here are other solutions. Organizations exist that will store a digital copy of your Health Care Directive (for a fee). You carry a card in your wallet with the organization’s contact information and your registration number. When needed, a communication to the organization gets a copy of the document to you (or the hospital). A search on the Internet for “health care directive storage” brought up a number of organizations offering this service. Fees run about $10 per year with a three to five year minimum for the organizations that I looked at.

Email–Free Alternative: But then there are “free” alternatives if you are even minimally computer capable. You can scan a copy of the document to your computer. Then email it to yourself as an attachment. Assuming you have an email account that can be accessed from any computer anywhere in the world (which is virtually every email account in existence), just keep the email in your In Box. It should stay there for years, if not forever, and be available to you whenever you need it. And, yes, every hospital is going to have a computer that you can use (in an emergency) for this purpose; but if they don’t, there’s a computer café down the street that you can use to access it for $10 or so.

On Line Storage-Free Alternative: Don’t like the email approach? How about just storing it in a DropBox account (SkyDrive, Google Drive, Apple iCloud) ? That account is also available from any computer in the world.

Card In Your Wallet: And if you are worried that you will be in a coma and won’t be able to access the document for the hospital, carry a card with the account name and password in your wallet. Just make sure you store no other sensitive information in that account because if your wallet is stolen, the thief will have access to everything in that account.

1/12/2014