Healthcare is a critical part of our lives at every stage. As small children, we experience healthcare through childhood illnesses, vaccinations, and occasional injuries. In college and in our young adult years, healthcare becomes more about episodic issues. Eventually, healthcare evolves into care for chronic conditions and health screenings, such as routine blood work, colonoscopies, and mammograms.

The part of healthcare we rarely address is end-of-life care. We all die eventually, but few of us have taken steps to share our wishes for what we would like to have happen when the time comes. According to a 2018 survey from The Institute for Healthcare Improvement, only 32 percent of individuals have had a conversation with loved ones about their end-of-life care (https://theconversationproject.org/about/). A 2020 study in the Journal of Palliative Medicine (https://www.liebertpub.com/doi/10.1089/jpm.2020.0111) reports that only 10–41 percent of individuals have formally addressed advance care planning by completing a written document to ensure that their wishes are met. Interestingly, the numbers are not skewed by younger individuals. A 2023 study showed that 31 percent of young adults aged 18–21 had filled out formal paperwork expressing their end-of-life care wishes (https://www.sciencedirect.com/science/article/pii/S2949923223000259).

April 16 is National Healthcare Decisions Day. This is a day for addressing the importance of advance care planning. It is a day where everyone is encouraged to speak with their loved ones about their end-of-life wishes.

It is also a day to document those requests to ensure that healthcare workers have the information they need to respect and carry out your wishes. In Massachusetts, the legal document used for this process is known as a Healthcare Proxy form. The form designates an individual to serve as your healthcare proxy. Your proxy dictates your healthcare wishes to your doctors and nurses in the event you are unable to speak for yourself. This could occur at the end of life, but it can also take effect anytime you are unable to make decisions for yourself – for example, if you are injured and in a coma. Healthcare proxy forms allow clinical staff to speak with your proxy about your condition. Therefore, your proxy will have access to your medical record with respect to your condition. Without the form, clinicians cannot speak with proxies due to federal privacy laws.

To fill out the form, you must first choose your healthcare proxy, then have a conversation with that individual and discuss what you would and would not like to have happen if you cannot make healthcare decisions for yourself. Once you have completed the form, you need two witnesses to attest to your signing of the form. The proxy does not need to sign the form – though the form needs to include their contact information. You don’t need a notary public or lawyer.

MIT Health is here to help facilitate this process. On April 16, from 3–5 pm in the Vannevar Bush Room, (10-105), we will be available to answer any questions you have. We will also have healthcare proxy forms on hand for you to sign, witnesses to attest to your signature, and a copy machine to provide you with free copies to give to your proxy, healthcare providers, lawyers, or any other people you think should have a copy of the document.

Importantly, if you are an MIT Health patient, we will scan your completed document directly into your electronic medical record. It will stay with you as long as you are an MIT Health patient. In the future, if you leave MIT Health, our medical records team can forward the document to other clinicians who need to have it on file.

Accidents and sudden debilitating illnesses are scary and unpredictable. When they occur, they are among the most stressful experiences your loved ones will ever deal with. This kind of planning can help to alleviate some of this stress. Discussing your healthcare wishes with your loved ones can be difficult. But taking the time to have those conversations – and filling out the proper paperwork now – is a huge step toward providing peace of mind for those who care about you.

Healthcare proxies help ensure your wishes are being met. And they give your loved ones comfort in knowing they are taking care of you as you would want. Join us on April 16 in the Bush Room to complete this important step.

You can learn more on our website at health.mit.edu/decisions.

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