By Patricia Bomba, M.D.

Wednesday April 16, 2014 is National Healthcare Decisions Day, when you are encouraged to initiate an ongoing conversation with loved ones and your physicians about your health care preferences, and also select a spokesperson (proxy) to make medical decisions on your behalf in case you can’t make them for yourself. These steps are part of a process known as advance care planning.

The goals of National Healthcare Decisions Day are simple:

・ To get everyone to select a spokesperson and complete Advance Care Directives. 
・ To increase awareness of MOLST (Medical Orders for Life-Sustaining Treatment). 
The MOLST form is a bright pink document that patients with advanced chronic illness and frailty complete with their doctor. The form then stays with the patient so end-of-life preferences will be followed as he or she moves through the health care system ─ facility to facility, physician to physician.

In March 2010, the Family Health Care Decisions Act was signed into law in NY State, enabling a patient’s family member ─ including his or her domestic partner ─ to make health care decisions when the patient is not able to do so. However, the law doesn’t eliminate the need for open and honest conversations with loved ones about your wishes and desires for medical care, or for advance care directives to be completed and copies on file with your doctors, your attorney and your family members.

Advance care directives include a health care proxy, a New York State Living Will and a Medical Orders for Life Sustaining Treatment form (MOLST form).

A survey conducted by Univera Healthcare showed that nearly nine of 10 upstate New Yorkers surveyed said it is important to have someone close to them making medical care decisions on their behalf if they were to have an irreversible terminal condition and were unable to communicate or make decisions. Yet, only 42 percent had designated a health care proxy to ensure their wishes are actually carried out.

Free advance care planning tools are available online at The site has informational videos, practical issues to consider, family discussion tips, guidelines for choosing a spokesperson, downloadable Health Care Proxy and MOLST forms, and a free planning booklet that describes Five Easy Steps to follow.Patricia Bomba, M.D., is vice president and medical director, geriatrics, Univera Healthcare. She was recently selected to serve on the Institute of Medicine’s Committee on Transforming End-of-Life Care.