Living will and health care proxy at first hand
A heart attack of a close relative, a stroke of the father, the diagnosis of a serious illness - these are shock situations that demand a lot of strength from those affected and their relatives. A feeling of helplessness quickly sets in when a patient or relative is caught up in the machinery of an emergency room or a large hospital. In addition to facts such as previous health conditions, dates and medication plans, far-reaching decisions often have to be made. For example, if a patient is no longer responsive after surgery, but it must be regulated whether life-sustaining measures are in accordance with the patient's wishes or not. Living wills and health care proxies provide security. Have you already drawn up a living will?
In the emergency room - suspected stroke
There are situations where everything has to happen quickly. Your father had a heart attack early in the morning, you talked to him calmly, called the emergency doctor, took his list of medications and insurance card with you to the emergency room, waited and now you are sitting at the bedside of this man who used to be so strong as an ox and lifted you up on his shoulders. He is pale, suddenly seems so vulnerable and much smaller than you remember him. He seeks your gaze, you take his hand. How delicate it is, lukewarm. Then the door opens and a 24-year-old, cheerful nurse comes to the bedside with a questionnaire. You think she will inform you what happened to your father this morning. Was it a stroke? What happens next? You automatically answer questions about where he lives, his health insurance and the medication he takes. Then comes this question: "Is there a living will or a health care proxy?" This jolts you out of your mental carousel and into a new one. You ask yourself if things are that bad for your father. In a matter of seconds, a film flashes before your mind's eye of what would happen if your father did not survive this. You thought you had done everything right, but now you are not so sure. You deny it. But the nurse smiles kindly. This is just a standard question, she can give you an information sheet about living wills and health care proxy. For the first time, you seriously think about filling out such a living will and health care proxy for your father and yourself. In the evening, your father comes home from the hospital at his own risk. No heart attack, no stroke, no abnormalities. Your father seems much more like he should be. Taller, fresher, still a little tired, but basically fit. That went well once again.
Living will, what is it actually?
With age, health problems such as heart attacks, strokes, fractures of the neck of the femur or dementia accumulate. Numerous illnesses and injuries raise a host of questions. One has to make decisions for one's parents in their presumed best interests, for example if they are unable to express themselves after a stroke. As long as one is reasonably healthy and independent, one represses the thought that one day one will no longer be able to make decisions for oneself. Yet something can happen to anyone at any age that puts them in precisely such a helpless situation that others have to decide what to do next. A great responsibility with often far-reaching consequences. In order to make these decisions easier for others and to ensure that decisions are made in one's own best interests, it makes sense to record one's own will in writing. This is done in a living will. A living will is primarily about one question: How do I determine what should be done medically if I am incapable of making decisions? If you want certain medical measures to be carried out or omitted if you are no longer able to decide this yourself, you specify this in a written living will. This is to ensure that the patient's will is implemented. The most important question is: How do I determine what should be done medically if I am unable to make decisions? Various points are determined in more detail, such as life-sustaining measures, procedures in the case of incurable severe brain damage, artificial nutrition and hydration, resuscitation, artificial respiration, dying at home or in a hospice, organ donation, to name a few. Nobody likes to think about these things, but it makes things easier for relatives if such questions are clarified in a living will.
Formulation aids in the form of text modules can be found on the website of the Federal Ministry of Health. The framework for dealing with living wills was laid down by the German Bundestag on 18 June 2009 in paragraph 1901a of the German Civil Code.
Who can write such a living will?
Every adult who is capable of giving consent can draw up an advance directive. And by the way, you can also revoke an advance directive informally at any time. Anyone who is not one hundred percent sure what is best for them in a worst-case scenario should consult a doctor or other expert. However, if the stipulations of a living will apply to the current life situation - i.e. if one cannot currently decide whether and which treatment one wants - medical practitioners and guardians or authorised representatives are bound by the living will.
The living will is valid even without notarisation
One of the many misconceptions that circulate about living wills is the assumption that they are only valid if notarised and only handwritten. This is wrong. In case of doubt about the business acumen of the author, a notary can be helpful - he or she can verify and certify the legal capacity. This establishes the will of the author of the living will as binding. There are pre-printed sample texts for the living will, in which one can merely concretise one's own will by ticking the appropriate boxes and sign it personally with place and date. Ideally, you should ask your family doctor to advise you and explain any points that are unclear - it is also best to have your family doctor sign as a witness.
What happens if I don't have a living will?
Without an advance directive, a legal representative decides on pending treatments together with the medical professionals on the basis of the presumed will of the patient. If they cannot agree, the legal representative must obtain authorisation from the guardianship court. Doctors are obliged to keep their patients alive. So it can happen that at the end of one's life, one is kept alive only by machines: Ventilated by a machine, fed through a stomach tube, diapered and unconscious, but still alive. Because many people do not want to subject themselves and their relatives to such a condition, which can last for years without any prospect of recovery, it makes sense to draw up a living will. Without a living will, the doctor does what he is obliged to do: preserve life, even if you yourself might wonder whether you can still call it life.
Where do I keep the living will?
To ensure that the living will can be found quickly in an emergency, it is best not to put it in a document folder in the cupboard at home, but to hand it over to the family doctor or another trusted person, who should then present it if necessary. In addition to medical professionals, it should also be possible to inform authorised representatives, guardians and the guardianship court quickly and easily about the existence of the advance directive.
The health care proxy - 4 pages full of trust
A health care power of attorney specifies who can take care of you and make important decisions in the event that you need care.
The individual points are
- Health care/need for care
- Residence and housing matters
- Authorities
- Asset management
- Post and telecommunications
- Representation in court
- Sub-power of attorney
- Advance care directive
- Validity beyond death
- Further regulations (individual)
On the website of the Federal Ministry of Health, you can also download the brochure "Betreuungsrecht - mit ausführlichen Informationen zur Vorsorgevollmacht". You should read this carefully before filling out the health care proxy (download form on the website of the Federal Ministry of Justice and Consumer Protection). After completing the health care proxy, the four pages should be firmly bound together so that nothing gets lost, especially not the signature and the health care proxy should be kept in the document folder or in an emergency folder in which, for example, the living will and other important documents are also kept.
