If you became unable to speak, who would make your medical decisions? That’s the question being raised throughout the country on April 16th. That date marks the 10th Annual National Healthcare Decisions Day, a nationwide event promoting the importance of healthcare choices and advance care planning. This day is a reminder for us all to take steps to ensure that our wishes are followed in times of crisis.

Advance medical planning is of particular importance to the LGBT community, because our support systems frequently fall outside of what is known as traditional “family” structures. The friends and loved ones you rely on and know best may have little power to speak for you when you need it most, unless you take specific steps ahead of time.

“Not having a health care proxy or an advance medical directive in place can be difficult,” said Kelli Abbott, community outreach counselor with the SAGECAP (SAGE Caring and Preparing) program at The LGBT Health Resource Center of Chase Brexton Health Care. “It’s important to have someone in charge of your health care decision-making, regardless of your relationship with that person,” Abbott adds. “If you don’t and, no close family are present in your life, these decisions could end up being made by doctors or family you may have no relationship with.”

Advance medical directives for LGBT individuals and their chosen families provide legally-binding instructions to caregivers about the patient’s wishes if they are not able to make those decisions themselves. LGBT individuals may also consider making out a will and delegating power of attorney.

The Maryland Volunteer Lawyers Service offers free advance planning for low- to moderate-income Marylanders. The organization can be reached at Mvlslaw.org, or by calling 410-547-6537.

There are two important ways to protect yourself: you can make your own decisions in advance by putting your wishes into a formal document often known as a Living Will, or you can use an advance directive to designate a Health Care Proxy (sometimes called a Health Care Agent, Surrogate, or Power of Attorney) who will make medical decisions on your behalf. Many people do some combination of the two, but it all depends on the individual person and situation.

Make Sure the Right Person is Making Your Medical Decisions if You Can’t

For more information:
• Resources on End of Life Decisions, National Resource Center on LGBT Aging – Lgbtagingcenter.org/resources/index.cfm?s=7
• National Healthcare Decisions Day – NHDD.org
• Advance Care Planning Resource List – Nhdd.org/#where-can-i-get-an-advance-directive
• In Maryland, the SAGECAP Program is available to assist members of the LGBT community with these and other important life-planning issues – Lgbtagingcenter.org/resources/resource.cfm?r=767

It’s important to note that simply completing advance directives isn’t enough; the people who might use them need to know that they exist and be able to access them when the time is needed. Give copies to your physicians, talk to friends and loved ones about them, and have detailed discussions with anyone you plan to name as a health care proxy (you should also provide them with the original copies of the forms). You might consider carrying a note in your wallet stating that you have an advance directive, along with instructions on where to find it or who to call in an emergency.

Thanks to marriage equality, same-sex spouses now have significantly more protection – a legal spouse would be the first in line to speak for someone who is incapacitated. That doesn’t make advance planning any less important, though. You should talk with your spouse specifically about your wishes, in the same way you would when designating a health care proxy, and you should be sure that you understand their wishes as well. This isn’t a matter of mistrust; knowing the patient’s own wishes can significantly ease the burden of making important decisions at a difficult time.

No one likes to talk about the “what ifs” of medical and end-of-life care, but it’s a necessary step that we each need to take to protect ourselves. The theme of this year’s National Healthcare Decisions Day is “It always seems too early, until it’s too late.” Please don’t put off these important steps until it’s too late – protect yourself now by putting your advance directives in place.

Monte Ephraitm is a licensed certified clinical social worker.