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A Caregiver's Dilemma

A caregiver's duties are hard enough and when advocate for medical purposes is also a part of the duties it becomes monumental. Frequently, a caregiver is also an advocate when medical appointments take place. Many families find it hard to understand the difficult nature of this position.

As a medical advocate the caregiver is not only advocating for the ‘best practice’ for the patient and also for many other entities that interact with the mode of treatment. First best practice means the provider needs to consider his or her ethics and the oath of ‘do no harm’. Then there is (in our world today) how much medical intervention is the correct amount. ‘Do no harm’ can stretch to the best practices when the patient is in the situation of an illness which is fatal. Now the caregiver must weigh the best interest of the patient, especially when the caregiver is the person holding the Durable Medical Power of Attorney. This person will have the say for all treatment and medical intervention. This can include the duty of last treatment, whether to withhold nourishment and water.

When the patient is married this duty frequently falls to the spouse. There are times when children of prior marriage will be the holder of the legal role and this may be a best practice. This becomes especially important and sometimes difficult when there are children of a prior marriage and the current marriage. . These decisions should be made as a family unit; this will leave no doubt that the person holding the document is the person given the role by the patient. Still many times there will be hurt feels and broken hearts as to who is the decision maker.

Then there is the role of Financial Power of Attorney, this person must look at financial information to determine the best financial path to take. Do we reverse mortgage the house or pool all resources to meet a financial obligation during this illness. This person has been given the power to make life changing decisions and maintain sound financial decisions. The role of Financial Power of Attorney is parallel to Durable Medical Power of Attorney. All decisions for either decision maker should be done with the input of medical persons (doctors), financial persons (accountants or attorneys) and family. If at all possible family can be gathered in a conference call linking individuals with the professionals all at one time.

Meetings should be held often once a quarter or more often is necessary thus allowing no one to be caught unaware of a crisis. By nature a crisis is just that and will happen when it is not convenient to gather all members of this family and professionals together. Having meetings will allow for some understanding of what and why the decision in question was made. Many times a calm head and a clear statement will add very tangible evidence to a decision heavy conversation.

Above all we are each responsible for making our own decisions. This is why it is important for us to convey our wishes to those (all of those) involved in the decision making process. When we have been made aware of the medical treatment and financial concerns we can then make an informed decision. There will be times when we will be in a situation requiring an immediate decision. This is the time we must trust those we gave the decision making power too.

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