Patients Rights and Advanced Care Planning
Check out these resources in Tigrinya and guidance below on how to prepare for unexpected medical events.
End of Life Care Planning: Interview with Dr Thomas Ateshim, Internal Medicine: https://bairexmedical.com/video/details/100/
Designate a family member or close friend as your Medical Advocate.
A Medical Advocate can be a family member, close friend or any individual who you trust. Your Medical Advocate should be present with you during ALL discussions with a doctor or nurse. If the Medical Advocate cannot be there with you in person, you can simply call and put them on speaker phone whenever you are having a discussion with a medical professional. Your Medical Advocate does not have to be the legal medical decision maker on your behalf. The benefit of having a Medical Advocate is to help you make decisions and to help ensure that the doctors and nurses have accurate information about your health status.
Know your rights.
It is important to know your rights before you or a loved one is in need of medical care. Here are some highlights from the Protecting Immigrant Families Campaign guides, which can be accessed here: https://protectingimmigrantfamilies.org/know-your-rights/
Everyone has a right to an interpreter when seeking health care or applying for health insurance.
Health care workers should not ask you for immigration status information.
Hospitals or doctors may ask for a photo ID to show that the person getting treatment is the same person listed on medical records or a prescription. If you do not have a photo ID, you can say “I am in need of medical care but do not have a photo ID.”
You do not have to provide your immigration status if you are applying for insurance for your children or a family member.
Many immigrants are eligible for health insurance. For more information, visit: https://protectingimmigrantfamilies.org/immigrant-eligibility-for-public-programs-during-covid-19/
You can still get health care without insurance. This includes emergency room care, community health centers, migrant health centers, free clinics, and public hospitals. To find a health center, visit: https://findahealthcenter.hrsa.gov
DC Residents: Translated resource guides are available in several languages, including Amharic: https://coronavirus.dc.gov/translated
Beware of fraud.
The COVID-19 pandemic has opened the door for scammers. Do not share your Medicare number, social security number or other personal information with anyone other than a hospital employee. Fraudsters are attempting to bill Medicare for sham tests or treatments related to the coronavirus and are targeting individuals to illegally obtain money or Medicare numbers. For more information on how to prevent Medicare fraud, visit: https://www.smpresource.org/Content/Medicare-Fraud/Fraud-Schemes/COVID-19-Fraud.aspx
Create an Advance Directive.
Advance directive is a written statement of a person's wishes regarding medical treatment. Advance directives need to be in writing. Each state has different legal requirements and forms, and some require a witness or notarization. You can ask a lawyer to help you with the process, but it is generally not necessary. Links to state-specific forms can be found on the following websites:
American Bar Association: https://www.americanbar.org/groups/law_aging/resources/health_care_decision_making/Advanceplanningresources/
AARP: https://www.aarp.org/caregiving/financial-legal/free-printable-advance-directives/
Review your advance directives with your doctor and your health care agent to be sure you have filled out forms correctly. When you have completed your documents, you need to do the following:
Keep the originals in a safe but easily accessible place.
Give a copy to your doctor.
Give a copy to your health care agent and any alternate agents.
Keep a record of who has your advance directives.
Talk to family members and other important people in your life about your advance directives and your health care wishes. By having these conversations now, you help ensure that your family members clearly understand your wishes. Having a clear understanding of your preferences can help your family members avoid conflict and feelings of guilt.
Carry a wallet-sized card that indicates you have advance directives, identifies your health care agent and states where a copy of your directives can be found.
Keep a copy with you when you are traveling.
Reviewing and changing advance directives:
You can change your directives at any time. If you want to make changes, you must create a new form, distribute new copies and destroy all old copies. Specific requirements for changing directives may vary by state.
You should discuss changes with your primary care doctor and make sure a new directive replaces an old directive in your medical file. New directives must also be added to medical charts in a hospital or nursing home. Also, talk to your health care agent, family and friends about changes you have made.
Consider reviewing your directives and creating new ones in the following situations:
New Diagnosis. A diagnosis of a disease that is terminal or that significantly alters your life may lead you to make changes in your living will. Discuss with your doctor the kind of treatment and care decisions that might be made during the expected course of the disease.
Change of Marital Status. When you marry, divorce, become separated or are widowed, you may need to select a new health care agent.
Every 10 Years. Over time your thoughts about end-of-life care may change. Review your directives from time to time to be sure they reflect your current values and wishes.
Create a living will.
A living will is a written, legal document that spells out medical treatments you would and would not want to be used to keep you alive, as well as your preferences for other medical decisions, such as pain management or organ donation.
In determining your wishes, think about your values. Consider how important it is to you to be independent and self-sufficient, and identify what circumstances might make you feel like your life is not worth living. Would you want treatment to extend your life in any situation? All situations? Would you want treatment only if a cure is possible?
Designate a Durable Power of Attorney.
A medical or health care power of attorney is a type of advance directive in which you name a person to make decisions for you when you are unable to do so. In some states this directive may also be called a durable power of attorney for health care or a health care proxy.
The person you name may be a spouse, other family member, friend or member of a faith community. You may also choose one or more alternates in case the person you chose is unable to fulfill the role.
Depending on where you live, the person you choose to make decisions on your behalf may be called one of the following:
Health care agent
Health care proxy
Health care surrogate
Health care representative
Health care attorney-in-fact
Patient advocate
Choosing a person to act as your health care agent is important. Even if you have other legal documents regarding your care, not all situations can be anticipated and some situations will require someone to make a judgment about your likely care wishes. You should choose a person who meets the following criteria:
Meets your state's requirements for a health care agent
Is not your doctor or a part of your medical care team
Is willing and able to discuss medical care and end-of-life issues with you
Can be trusted to make decisions that adhere to your wishes and values
Can be trusted to be your advocate if there are disagreements about your care
Physician Orders for Life-Sustaining Treatment (POLST) or Medical Orders for Life-Sustaining Treatment (MOLST).
In some states, advance health care planning includes a document called physician orders for life-sustaining treatment (POLST). The document may also be called provider orders for life-sustaining treatment (POLST) or medical orders for life-sustaining treatment (MOLST).
A POLST is intended for people who have already been diagnosed with a serious illness. This form does not replace your other directives. Instead, it serves as doctor-ordered instructions — not unlike a prescription — to ensure that, in case of an emergency, you receive the treatment you prefer. Your doctor will fill out the form based on the contents of your advance directives, the discussions you have with your doctor about the likely course of your illness and your treatment preferences.
A POLST stays with you. If you are in a hospital or nursing home, the document is posted near your bed. If you are living at home or in a hospice care facility, the document is prominently displayed where emergency personnel or other medical team members can easily find it.
A POLST also indicates what advance directives you have created and who serves as your health care agent. Like advance directives, POLSTs can be canceled or updated.
Forms vary by state, but essentially a POLST enables your doctor to include details about what treatments not to use, under what conditions certain treatments can be used, how long treatments may be used and when treatments should be withdrawn. Issues covered in a POLST may include:
Resuscitation
Mechanical ventilation
Tube feeding
Use of antibiotics
Requests not to transfer to an emergency room
Requests not to be admitted to the hospital
Pain management