Financial advisors may need to take extra precautions with their clients when it comes to advance care planning. As Daniela Lamas, a doctor at Brigham and Women’s Hospital in Boston, found out, even the best of intentions and exhaustive conversations sometimes aren’t enough to ensure that patients’ advance care directives are actually followed, she writes in The New York Times.
Don’t Blame the Doctors
Doctors do their best to have in-depth discussions with patients about prognosis and care, she writes. Patients are also encouraged to discuss advance care plans with their family, according to Lamas. But critical information is often not properly documented, unorganized across different electronic records or simply difficult to retrieve, according to Lamas.
Through a year’s worth of research and interviews with clinicians, Lamas found that the problem of information being input but not found at critical moments is very common, she writes in The New York Times. These include stories of patients getting transferred to nursing facilities without any directive from them beforehand, getting intubated despite not wanting to, or ending up in hospitals with completely different electronic medical records, according to Lamas.
Current rules on advance care planning are lacking, she writes. Unlike regulations on allergies, for example, which require that all patient records have a medicine allergy list, there’s only a rule to have the ability to include advance directives — but there’s no rule to ensure they’re retrievable, according to Lamas.
There are also no nationwide standards for advance directives so practices across hospitals vary, she writes. At Brigham and Women’s Hospital in Boston, where electronic records on advance care planning that shows notes, directives, healthcare proxy forms and more, according to Lamas. But patients can still end up in a situation they explicitly asked to avoid, according to Lamas.
In the meantime, advisors could take the necessary steps to ensure that their clients have the necessary forms filled out and updated and that their family is involved and aware of their wishes.
