Right now is the best time to answer future urgent health care questions

Taking charge

“Any new symptom in an older person should be considered a drug side effect until proven otherwise.”

That quote, from a geriatric specialist, appeared in an e-mail I sent you last year. And now that quote haunts my friend Dan.

Hidden dangers

Dan’s dad was elderly, but in generally good health. That is until an injury required a hospital stay. But it didn’t end there. It was followed by an infection, surgery, and, of course, painkiller use throughout. That lead to episodes of dementia and within just a few weeks, Dan’s father succumbed to respiratory failure.

Toward the end, he was in a nursing home. Dan admits that he’s not sure exactly what drugs his father received, and now he wonders what role those drugs might have played in his father’s death.

As I’ve told you before, dementia symptoms are common in older people taking painkillers, antidepressants, sleep-aids, and other drugs. The risk of those symptoms climbs even higher when the patient is in the hospital — especially if it turns into a long stay.

And last year, the Department of Health and Human Services warned that the use of antipsychotic drugs in elderly residents of nursing homes not only violate government standards, but also increase the risk of premature death. (One of those drugs is haloperidol (brand name Haldol) which may DOUBLE the risk of death, compared to another widely used antipsychotic.)

Most people aren’t aware of these dangers. That’s one reason I’ve told Dan to not be too hard on himself. It can be extremely difficult for a caregiver to stay focused and ask all the right questions when he’s blindsided by complicated and quickly changing health issues that he knows little or nothing about.

But even if Dan had tried to get the details of his father’s care, he might have been rebuffed by hospital or nursing home staff because no one was designated as Healthcare Power of Attorney (HPA).

If Dan had been officially appointed as his dad’s healthcare proxy, he would have had access to his father’s medical records, as well as the final word in decisions about what drugs could or could not be used.

I know it’s disturbing to plan for a situation you never want to experience. Just the idea of sitting down to imagine all the “what ifs” almost feels like you’re resigning yourself to that terrible fate.

But in fact, you’re doing the exact opposite. When you and your loved ones plan for a worst case scenario, you’re putting yourselves in control so you’ll have unquestioned authority to make the best decisions as quickly as possible.

HPA laws vary state to state, so it’s best if you consult an attorney. But in most cases all that’s required is a simple letter signed by witnesses.

And while these health issues are all out on the table, it’s also a good time to draw up a Living Will with specific instructions on how you want to be cared for if you’re unable to make those decisions yourself.

Making those tough decisions now is the best way to make sure someone who cares about you is able to make them in the future.

Sources: 
“Specific antipsychotic drugs increase risk of death in elderly dementia patients” BMJ Group Press Release, February 2012, group.bmj.com