15 Topics to Discuss with Your Health Care Agent
1. How would you describe your current health status? If you currently have any medical problems, how would you describe them?
2. If you have current medical problems, how do they affect your ability to function?
3. Who is your current doctor and do you like him or her? Why?
4. Do you think your doctor should make the final decision about any medical treatments you might need?
5. How important is independence and self-sufficiency in your life?
6. If your physical and/or mental abilities were decreased, would that change your attitude toward independence and self-sufficiency? How?
7. What is important to you when you are dying (e.g., physical comfort, family members present, location, etc.)?
8. Where would you prefer to be when you die?
9. Do you think you would want any of the following medical treatments performed on you?
a. Kidney dialysis (used if your kidneys stop working)
b. Cardiopulmonary resuscitation (CPR) (used if your heart stops beating)
c. Respirator (used if you cannot breathe on your own)
d. Artificial nutrition (used if you cannot eat food)
e. Artificial hydration (used if you cannot drink fluids)
10. How do you feel about life-sustaining measures if you have a terminal illness?
11. How do you feel about life-sustaining measures if you are in a permanent coma?
12. How do you feel about life-sustaining measures if you have a chronic illness such as Alzheimer’s disease?
13. Do you have any religious beliefs that affect your views on end of life care?
14. Do you want to donate any part of your body to someone else at the time of your death? (This is called “organ donation.”)
15. Do you have a living will? This is a legal document that says what medical treatments you want and do not want when you are dying.
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