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25 Topics to Discuss with your Health Care Agent

Before your health care agent signs any forms or makes decisions for you, you should discuss your beliefs and wishes with him or her. The following questions may be helpful as you have this discussion. There are no right answers. You should answer these questions based on your own beliefs and share these beliefs and wishes with your health care agent.

1. Do you think it is a good idea to sign a legal document that says what medical treatments you want and do not want if you cannot speak for yourself?

2. Do you think you would want to have the following medical treatments? In what circumstances?

Kidney dialysis (used if your kidneys stop working) - a procedure to clean the blood of patients whose kidneys are not working.

Cardiopulmonary resuscitation, also called CPR (used if your heart stops beating) - a number of medical procedures that can be used to keep blood circulating and maintain breathing in a person whose heart and/or breathing has stopped.

Respirator (used if you cannot breathe on your own).

Artificial nutrition (used if you are unable to eat food) and artificial hydration (used if you are unable to drink fluids). You will receive food and water by tubes inserted through the nose to the stomach, surgically inserted to the stomach, or through IVs (intravenous tubes or tubes inserted through your skin into your veins).

3. Do you want to donate parts of your body to someone else when you die? (This is called "organ donation.")

4. How would you describe your current health? If you have any medical problems, how would you describe them?

5. If you have medical problems, in what ways, if any, do they affect your ability to live your life?

6. How do your feel about your current health?

7. If you have a doctor, do you like him or her? Why?

8. Do you think your doctor should make the final decision about any medical treatments you might need?

9. How important is "independence" and "self-sufficiency" in your life?

10. If your physical abilities or your mental abilities become limited, would that affect your attitude toward independence and self-sufficiency? How?

11. Do you have any general comments about the value of independence and control in your life?

12. Do you expect that your friends, family and/or others will support your decisions about medical treatment you may need now or in the future?

13. What will be important to you when you are dying (for example, physical comfort, no pain, family members present, etc.)?

14. Where would you prefer to die?

15. What is your attitude about death?

16. How do you feel about the use of life-prolonging treatments like artificial food and water and artificial breathing machines (ventilators) if you are terminally ill?

17. How do you feel about the use of life-prolonging treatments if you are in a permanent coma?

18. How do your feel about the use of these life-prolonging treatments if you have an irreversible chronic illness (for example, Alzheimer's disease)?

19. Do you have any general comments about your attitude about illness, dying and death?

20. What is your religious background?

21. How do your religious beliefs affect your feelings about serious or terminal illness?

22. Are your feelings about death supported in your religion?

23. What does your faith community, church or synagogue see as the role of prayer or religious sacraments in an illness?

24. Do you have any general comments about your religious background and beliefs?

25. What else do you feel is important for your agent to know?

If, over time, your beliefs or feelings in any area change, you should tell your health care agent. You also should tell your health care agent if your health changes or there is a new diagnosis. If you are told you are terminally ill, discuss this situation with your agent. You must prepare your agent well if you want him or her to speak for you.

This information was prepared by AARP.

March 26, 2002