The Significance of Keeping Health Care Directives Current
An advance health care directive – often called a living will – is a document in which you clearly define your health care wishes, should you be unable to speak for yourself. While most people imagine they will not need a living will until they are older and unable to articulate their own wishes, the need for an advance care directive could present at any time with a sudden accident or an unexpected illness. Therefore, maintaining an up-to-date advance directive will give you peace of mind that your wishes will be carried out.
Making plans now
BCHIP offers a free advance care planning consultation for Bucks County residents. Our team helps you walk through all the questions you should consider when developing your plan. These questions include what kind of life-sustaining medical care you would like to have and under what conditions; whether or not you want to donate your organs; what you consider an acceptable quality of life; and any other instructions from the perspective of your own personal moral or religious beliefs.
You will also need to name a medical power of attorney, also called a proxy, who will ensure that your wishes are carried out. It is important to have a second and even a third medical agent, in case the first person is unavailable and decisions must be made imminently regarding your health.
It is very important to have serious conversations with your loved ones about these issues. Choose medical proxies who agree with your wishes and whom you are confident will fulfill your advance directive as it is defined. Many people shy away from such important conversations, but once they have been broached, future discussions should be easier.
Updating your advance directive
It’s very important to review your document on a regular basis to see if it is still accurate. Some reasons to review or update include:
- An event in your life that may have changed your views on some aspect of health care or end-of-life care
- Divorce, death in the family, or other relationship changes that may require you to change your proxies
- A new diagnosis, such as cancer, Parkinson’s disease, or dementia, which may require changes in your wishes regarding health care and comfort care. You must be “of sound mind” in order to make a legally binding document, so it is important to review an advance directive while one’s mental acuity is still strong
- Decline in one’s ability to live independently or deterioration of a current health condition
- It has been more than five years since you have reviewed the document
If you are changing your healthcare directive, it is best to create a new document. Then discuss the document with your proxies and loved ones again and have it notarized. Our free consultation program can help you with the process of reviewing and replacing an older directive. You can include other members of your family in the consultation. That might help you begin the conversation with them and allow you to think through the important questions regarding your future in the presence of those who love you and want the best for you. Click here to schedule your free consultation.
The Crucial Role of Vaccines for the Elderly
Vaccinations play a pivotal role in safeguarding older adults. Our ability to fight off infections and maintain our immune system declines as we age. Many of us who are elderly are also in situations where contagious conditions are easily spread. This creates situations where vaccine use is critical for older Americans to stay healthy and live fully.
Vaccines are a safe and effective way for older adults to build immunity against infectious diseases, reducing the chances of serious illness, hospitalization, and complications. Vaccines have been used for centuries and are one of medicine’s greatest success stories.
Why are Vaccines Important for Elderly Patients?
As people grow older, their immune response diminishes, leaving them more susceptible to infections and severe consequences. This makes vaccines a vital component of maintaining health and preventing diseases that can have dire implications:
- Vaccines help build immunity and protect against various preventable diseases that can be particularly severe in older age. Influenza, pneumonia, shingles, and pertussis are among the illnesses that vaccines help prevent. For elderly individuals, the consequences of these diseases can be severe, leading to hospitalization, complications, and, in some cases, even death.
- By preventing diseases through vaccination, the healthcare burden on elderly individuals and the healthcare system is significantly reduced. Vaccines not only protect the individual but also contribute to overall public health by minimizing the spread of infectious conditions within the community.
- Vaccinations that prevent or lessen the disease burden on the elderly save money for individuals and the healthcare system. Money not spent on treating preventable diseases can be saved or spent elsewhere.
- The impact of preventable diseases on the quality of life for older adults cannot be overstated. Chronic conditions resulting from infections can lead to long-term health issues, affecting independence, mobility, and overall well-being. Vaccination serves as a proactive measure to preserve and enhance the quality of life for the elderly.
It’s not just that elderly immune systems aren’t what they used to be. Other issues make older people more susceptible to contagious diseases:
- They may live with multiple people who may spread diseases, whether that’s at home with family, in assisted living facilities, or in nursing homes
- Their ongoing, chronic conditions take a toll on their health and their ability to fight infections
- Medications for these conditions may impair their immune response
- They may not get enough sleep or exercise or eat healthy food
- Because of their age or medical, financial, or family situations, they may have chronic stress and anxiety to deal with, weakening their immune system
Elderly Americans have a lot on their plates. Though many enjoy good health and stability later in life, retirement may not be the picture-perfect time described in ads for retirement planning services or 55+ housing developments. Many have low incomes, insufficient savings, substandard housing, and an obligation to care for their grandchildren. No matter their situation, the last thing older Americans need is a severe infection that may have been avoided or lessened by a vaccine.
Do You Have Questions or Concerns About Vaccines?
The elderly and their family members should consult with their healthcare professional when deciding which vaccine they should get and when. They shouldn’t rely on rumors, misinformation, and conspiracy theories spread by social media, friends, and others.
We can help out, too. Call the Bucks County Health Improvement Partnership at 267-291-7882 or complete our online contact form.
Trying to Quit Smoking? Use Tech
According to the CDC, smoking causes about one in five deaths in the U.S. each year, which makes it the #1 cause of preventable deaths. This includes one-third of all cancer and 90% of all lung cancer deaths, and it is a major risk factor for heart disease and stroke. The addictive nicotine in cigarettes and the many other toxic chemicals used in tobacco products damage every aspect of the smoker’s health, yet many people struggle to quit, even with this knowledge.
According to some studies, only about 5% of people are able to quit smoking without some smoking support group or quit-smoking product. At BCHIP, we provide a Quit Smoking Program that supports people trying to quit. We can also refer you to a doctor who can provide nicotine replacement therapy. Other products and technology have been developed to help people to kick the nicotine habit.
Apps
The variety of apps available to help you quit smoking is truly dizzying. As different people respond to different approaches, the apps can have very different support methods. One creates a personalized quit plan, whether you want to go slow or quit cold turkey, tracks how much money you’re saving by not smoking, and offers reward badges for success. Another takes a more “mindfulness” approach, with guided meditations to help ease the stress of quitting.
If you’re motivated by statistics, there are apps that track your decrease in usage, the number of hours added to your life, the W.H.O. indicators for improved health as you decrease smoking, and other interesting personalized statistics. The cleverly-named “Get Rich or Die” app focuses on how much money you are personally saving, while at the same time saving your life.
Other apps include a “craving timer” which reminds you of your goals as you fight off a craving.
Wearables
Wearable devices are being developed and are starting to be available in the market to help you quit smoking. Like apps, they have different approaches.
A simple item, sold as an anti-smoking, anti-vaping necklace, helps the user take relaxing, long breaths to calm anxiety. A wide variety of inhalers with aromatherapy or citrus also help calm cravings and anxiety. Though unproven, some people get relief from magnetic bracelets or from ear or hand acupressure devices.
Though not yet widely available, some other wearables are being developed, like a necklace, called Smokemon (like Pokémon), with thermal sensors that track a cigarette going to and from the mouth. This can help the smoker and a health coach track occasional slips and determine what triggers caused those slips and how to avoid them in the future. The necklace can be synced to send a text or video message to the smoker to send encouraging reminders to help the person stay on track.
Another method being developed is a tracking program in a smartwatch that can track hand-to-mouth movements indicative of smoking. Wearable cameras designed to alert the presence of cigarettes or other smoking triggers have been floated, but these carry privacy concerns.
Successfully quitting
According to the Department of Health and Human Services (HHS), nearly 70% of adults who smoke say they want to quit. Combining counseling with medication can more than double the chance of quitting successfully. Apps and wearables can enhance the benefit of counseling alone, or counseling and medication if your doctor believes medication or nicotine replacement therapy is warranted.
BCHIP offers a 5-session Quit Smoking Programboth virtually and in person, at two different locations for your convenience. Nicotine replacement therapy is available for those who qualify. Click HERE to register, or call (267) 291-7882 for more information. Smoking kills, on average, 440,000 Americans each year. That’s a really good reason to quit.
Are Vaccines Safe?
Vaccines have been a cornerstone of public health for over a century. They have saved millions of lives over that time and helped eradicate deadly diseases like smallpox and polio. Despite their remarkable success, vaccines continue to be a subject of controversy and misinformation. Here at BCHIP, we believe that Bucks County residents should have access to safe and effective vaccines.
Here are reasons why vaccines are safe.
Extensive Testing and Approval Process
Vaccines undergo an extensive and rigorous approval process before reaching the general public. This process involves multiple phases of testing to ensure both safety and efficacy. This includes preclinical testing, usually on animals. If the vaccine appears safe, it moves onto clinical testing where larger and larger groups of people use it. Their responses are studied to see if the vaccine is safe and effective.
Regulatory agencies like the U.S. Food and Drug Administration (FDA) carefully review the data from clinical trials before granting approval. They assess the vaccine’s safety, efficacy, and manufacturing quality.
Ongoing Monitoring
The process doesn’t end with approval. Vaccines are continuously monitored for safety through multiple systems, such as the US Vaccine Adverse Event Reporting System (VAERS). Healthcare professionals and the public can report any adverse events related to vaccines, and this data is closely analyzed to detect any unusual patterns or safety concerns.
Thorough Manufacturing Standards
Vaccine production adheres to stringent quality control and manufacturing standards. The World Health Organization (WHO) and other regulatory bodies oversee vaccine production facilities to ensure they meet these standards. This helps guarantee that vaccines are produced consistently and safely.
Herd Immunity
Vaccines protect individuals and contribute to a concept known as herd immunity. When a large portion of a population is immune to a disease, either through vaccination or previous infection, it creates a barrier that prevents the disease from spreading quickly. This protects those who cannot be vaccinated due to age, medical conditions, or allergies.
Historical Success
Vaccines have a track record of success in preventing and eradicating diseases. Smallpox, a once-devastating disease, was completely eradicated thanks to the smallpox vaccine. Polio is nearing global eradication, and the cases of many other conditions, such as measles and rubella, have been significantly reduced.
Expert Consensus
The scientific and medical communities overwhelmingly support vaccination. Leading health organizations, including the World Health Organization (WHO), the Centers for Disease Control and Prevention (CDC), and the World Medical Association, advocate for vaccines and endorse their safety. These organizations rely on extensive research and expertise to make their recommendations.
Adverse Events Are Rare
While vaccines can cause side effects, serious adverse events are extremely rare. Most side effects, such as soreness at the injection site or a low-grade fever, are mild and temporary. Severe adverse events occur in a tiny fraction of cases. These cases are thoroughly investigated, and the benefits of vaccination are weighed against the risks.
Because of social media and the COVID-19 outbreak, there has never been more false information and accusations about vaccine use so readily available. Vaccines are a safe, crucial tool in preventing deadly diseases and protecting our community. Your doctor is your first line of information and can help you make informed decisions about vaccine use for yourself and your family.
Do You Have Questions or Concerns About Vaccines?
If so, let’s start the conversation. Call the Bucks County Health Improvement Partnership at (267) 291-7882 or complete our online contact form.
Relapsing as You Quit Smoking
While you’re trying to quit smoking, or even after you’ve successfully quit, you may give in to the craving for a cigarette. When this happens, some people end up feeling like they blew it and just give up and go back to smoking regularly. Try to resist that reaction. It is common to slip up, and you haven’t failed. Here in Bucks County, our Smoking Cessation program will give you the tools to successfully handle a craving.
Slip vs. relapse
It is not uncommon for a smoker who is quitting to have a cigarette or two. Even after quitting, you may find yourself in the presence of a smoker and just can’t resist sharing a cigarette. You may be stressed and think “I really need a cigarette” and you give in. This is what we call a slip.
A relapse is when you go back to smoking regularly. Sometimes a slip can lead to a relapse, especially if you smoked many cigarettes a day. Sometimes just one puff is enough to unravel all your hard effort to quit.
When this happens, it’s understandable to be disappointed, but be gentle with yourself. Quitting any habit is difficult, and overcoming nicotine addiction is especially hard.
Reclaiming your freedom
Maybe you’re lucky enough to be able to only have that one cigarette and go back to being smoke-free. If so, congratulations! But many people need a little more help to continue on their journey toward a smoke-free life.
Every incident is an opportunity to learn and grow. Look at the situation and ask yourself what may have triggered the need for the cigarette. Was it the location? The people? The events? Did you really need it, or did you just want it? What were you thinking about when you took the smoke? This self-examination can help prevent you from relapsing.
But what if you have already relapsed? Don’t worry, you now know you can quit, it is possible for you, and you can do it again. Relapsing is now part of your journey, and it’s an opportunity to learn where you still need to become stronger, what situations you need to avoid, and what support you need to prevent it from happening again.
If you haven’t tried a smoking-cessation support group, try it now to help you finish your success story. We offer a free, 5-week Quit Smoking Program to help you. You can choose between an in-person or virtual group. If you already used a support group, don’t be embarrassed to join again! You will probably be able to help others on the journey because they will be able to learn from the lessons you share. And they will be more determined to cheer you on to a final victory over nicotine.
If someone you love relapses
What if it’s not you who relapsed but someone you love? Take these lessons to heart and don’t make your loved one feel shame. Try to remind your loved one why he or she decided to quit in the first place. Discuss the benefits of being smoke-free and find a support group to help your loved one succeed.
With failure comes progress. Don’t give up, join our Quit Smoking Program to give you the support you may need, and get back to being smoke-free.
Unlike Most Myths, Those About Vaccines Cause Harm
If you are confused about vaccine safety, please know that what you hear as sound bites are often myths. We grew up with myths. George Washington as a child, chopped down a cherry tree and admitted it to his father. Atlantis was an ancient, advanced civilization that sank into the ocean. Columbus discovered America. These falsehoods may confuse, but no one died because they believed George Washington could not lie.
Vaccine myths are another story.Vaccine use can save lives. One study estimates that in the first five months of their use, COVID-19 vaccines saved about 139,000 lives, according to the National Institutes of Health.
The COVID-19 pandemic was a perfect storm for vaccine criticism. Before it happened, a small group publicly opposed their use. Through social media and media outlets, they found a much larger audience of Americans frustrated by and skeptical of the government’s response to the infection. As a result, many of us who never questioned vaccine use before refuse to get them. This is a bad idea for these individuals and the community. Here are some vaccine myths and the reality.
Vaccines are a personal choice.
Yes and no. If you’re conscious and mentally competent, you decide what healthcare you get and don’t get, including vaccines. However, unless there’s an exemption, some workers in the healthcare field, members of the military, and children attending childcare or school in Pennsylvania must be vaccinated.
Smoking tobacco can also be seen as a personal choice, but you’re impacting others with second-hand smoke. Widespread vaccine use prevents some diseases. If they’re not used, it helps their spread and other people are harmed, just as tobacco smoke can harm someone not smoking. It may be a personal choice, but not using vaccines impacts more people than you.
Vaccines are toxic.
Depending on the vaccine and the person, a vaccine may be toxic. But, overall, they are safe and effective. The chances of a severe adverse reaction to a vaccine are tiny. On average, of a million people who receive vaccinations, one or two individuals may suffer a severe reaction, according to the U.S. Department of Health and Human Services. If all 13 million people in Pennsylvania received a vaccination, approximately between 13 and 26 people would have a severe reaction. In comparison, your chances of dying in a vehicle accident are about one in 93
If you have any questions or doubts about the safety of a vaccine, contact your healthcare provider to discuss the chances that you may have a serious reaction or complication if you use it.
I know what is best for my child.
You may know many things that are best for your child. You know their personality, how they might respond to a situation, and their likes and dislikes. Unless your child had a specific reaction to a particular vaccination, or you’re a healthcare professional, if you think your child will have a bad reaction or complication to a vaccine, it’s a pure guess, probably based on false information. If you have concerns about your child’s use of vaccines, talk to your pediatrician.
Vaccines cause harm.
Vaccines can cause harm, but it’s extremely rare. Generally, a child receiving a vaccine has less than a one-in-a-million chance of suffering a bad reaction, and the risk of permanent harm is even smaller. You probably expose yourself and your child to far greater risks without thinking about it. Injuries due to a firearm, swimming pool, or vehicle are far more likely.
Do You Have Questions or Concerns About Vaccines?
If so, let’s start the conversation. Call the Bucks County Health Improvement Partnership at (267) 291-7882 or fill out our online contact form
Updating Healthcare Directives
It’s always a good idea to look at your estate planning and advanced healthcare directive documents every year. Things can change over a year: your health or financial situation may change, someone listed in your documents may pass away or move, or your attitudes about a particular procedure or intervention may change. So take a look every year and make sure your documents still align with your wishes.
Estate planning usually is understood to refer to your finances and your property – what is considered your “estate” when you die. You should certainly review your will and other estate decisions yearly to make sure you are leaving your wealth to the people or organizations you wish to have them.
But another important aspect of estate planning is your advanced healthcare directive, also called a “living will.” Your living will allows you to specify:
- Whether or not you want life-sustaining medical care, what kind, and under what situations
- Whether or not you want to donate your organs or tissues, if you are a candidate
- What you consider your acceptable quality of life
- What comfort care you would like provided
- Any other instructions you would like followed, regarding moral, religious, or ethical considerations
- What family member(s) or friend(s) will be responsible for carrying out these directives if you are unable to make these decisions for yourself (your medical power of attorney)
When you first created your living will, you probably went over these questions thoroughly and gave them a great deal of thought. Over the course of the year, however, you may hear of new medical technology that you do or don’t want; you may change your mind about whether or not you’ll donate your organs; you may lose a family member who was named as a medical power of attorney.
For instance, maybe you have a friend who benefited from a ventilator during Covid-19, giving your friend time to recover. If you said “no ventilators” in your living will, you may want to modify that directive, such as adding “if there is no expectation of recovery.”
You should also have another conversation with your medical power of attorney and alternate powers of attorney. It’s a good idea to have two other people mentioned in case the primary person is unavailable in an emergency or passes away before you’re able to change your living will. Discuss your preferences and make sure the people you have named still hold the same views you do and will carry out your wishes.
Updating your documents yearly will ensure that your wishes will be fulfilled, if you are ever unable to speak for yourself.
What Is Nicotine Replacement Therapy?
If you are a smoker and you want to stop smoking, we at BCHIP applaud your decision. Smoking and other nicotine use cause a wide variety of serious health problems throughout the body. The statistics are sobering:
- Cigarette smoking increases risk of death from all causes in both men and women
- Smoking is a factor in many different types of cancer
- It increases risk of developing lung cancer 25 times and causes 90% of lung cancer deaths
- Smokers are 12 to 13 times more likely to die of COPD
- Smoking increases risk of coronary heart disease and stroke, the two leading causes of death in the U.S., by 2 to 4 times
- It damages blood vessels, increasing the risk of blood clots that can reduce blood flow to the brain, legs, and skin
- Smoking harms nearly every organ of the body
- Smoking can reduce fertility and cause low birthweight, miscarriage, birth defects, ectopic pregnancy, and stillbirth
- Smoking has been found to affect bone health in women
- Smoking damages teeth and gums and can cause tooth loss
- It can damage your vision and increase risks of blindness, cataracts, and macular degeneration
- Smokers are 30%-40% more likely to develop type 2 diabetes and are more likely to experience complications from the diabetes
Besides these very serious health risks, smoking discolors teeth, causes bad breath, and leaves your clothes smelling like smoke. It can also trigger asthma or other problems in those you love who frequently breathe in second-hand smoke.
So there are many very strong reasons to quit smoking, but because nicotine is addictive, it is extremely difficult to break the habit.
There is also an emotional component to cigarette smoking that needs to be addressed. It helps to have a support system like our free Quit Smoking / Tobacco Cessation Program that will help you stay on track and successfully quit. Nicotine Replacement Therapy (NRT) is available for those who qualify. This five-session program is available both in-person and virtually.
Nicotine Replacement Therapy
NRT supplies low doses of nicotine in order to cut down on cravings for nicotine, lessen physical withdrawal symptoms, and help the person more easily quit. It is especially helpful for those who smoke heavily. The more nicotine coursing through your system, the more difficult it is to overcome the addiction, and many people need the help of NRT to successfully break the habit.
NRT does not contain many of the toxins found in cigarettes or other nicotine products. NRT comes in many forms, including gum, inhalers, lozenges, nasal spray, and skin patches. Patches and gum seem to be the most effective because people are more likely to use them properly. Discuss with your doctor which form may be best for you and what dosage you may need.
Nicotine use can cause side effects, and NRT is no exception. Since the nicotine dosage is low, the chances of side effects are small, but you may experience headaches, nausea or other digestive problems, and difficulty sleeping (usually with the patch, and usually only the first few days).
It is very important NOT to smoke while using NRT. The combined nicotine level could be quite high, causing increased toxins in your body.
NRT is not enough
As mentioned, there is an emotional component to smoking addiction that needs to be addressed in order to successfully kick the habit. Our program will provide you with proven techniques as well as emotional support and mutual encouragement as you face this challenge with others. Visit us at bchip.org/quit-smoking-programs today for more details and to register.
When Family Members Won’t Get Vaccinated
During the last two years, we have seen many Bucks County families divided over Covid vaccination status. Suppose you’re immuno-compromised and you feel unsafe around people who have not received a vaccination or who may have any kind of cold or illness. You have the right to advocate for yourself within your family, and you may decide not to see certain family members for the time being.
Short of serious health concerns, however, try to handle this difference of opinion as you would handle most other strongly-held differences, such as religion or politics: with respect and patience.
One-on-one conversations are preferable, so the other person does not feel ambushed. You will also have more control over the situation because if you want to be calm and patient but someone else who holds your opinion is more hot-headed, the conversation can actually be counter-productive.
That said, if you know the conversation is likely to get heated or emotional, ask a level-headed person whom you both respect to moderate. If it begins to get intense, take a break.
Try to maintain neutral, non-aggressive, and non-accusative body language, tone of voice, and word choice. Don’t say things like “You obviously don’t care about others.” Ask, rather, “What thoughts do you have about how your decision impacts others?” That may still be a difficult question to hear, but it assumes the other person has thought about it, which is a respectful assumption, and it opens up the opportunity for the other person to explain his thoughts on the matter.
Try to explain your position without being preachy. Stick to what you see as the facts and ask your family member to do the same. Facts should be supported by reliable sources. Try not to dominate the conversation. If necessary, set a timer to give each person five minutes of uninterrupted talking, and take turns.
Go into your conversation with the mindset of creating peace and making progress in your understanding of each other’s position. You may both find common ground and even come closer together in your views.
In the end, family is family. Do whatever you can to maintain that mutual love and respect that all family members deserve. You can’t control other people’s actions, but you can control your own. For your part, try to maintain that sense of family bond. Even if there is tension for a time, try to keep lines of communication open so your relationship can continue moving forward and eventually move past this difference.
Whom to Leave in Charge of Your Care: Choosing your Medical Power of Attorney in Bucks County, PA
An estimated 75% of all Americans will at some point be in a medical situation in which they cannot communicate their wishes. While it isn’t pleasant to think about and the conversation may be awkward, it’s important to take time to develop an advanced medical care plan, including a medical power of attorney, in case an accident or unexpected health condition leaves you suddenly unable to make decisions for your own healthcare. Having someone to advocate for you and your wishes is critical when you can’t advocate for yourself.
PA Law and health care decisions
Pennsylvania does have a standard hierarchy of authority that it follows if an adult is unable to make health decisions and has not named a healthcare agent. Healthcare providers will turn to others for guidance on your care in the following order:
- Your spouse
- An adult child
- Either of your parents
- An adult sibling
- An adult grandchild
- A close friend
If the prior person is not available (for instance, if you have no spouse) medical personnel will go to the next available person for guidance (in this case, your adult child).
But what if you have more than one child, or your spouse or children have different views on healthcare than you do? Naming your medical power of attorney solves this problem.
What a medical power of attorney does
A medical power of attorney goes by a number of titles: healthcare power of attorney, durable power of attorney for healthcare, and healthcare proxy. These titles all designate a person who will make healthcare decisions when a doctor determines the patient cannot make decisions for himself. This may include when the patient is in a coma, is taking necessary medication that impairs judgment, or is suffering from cognitive decline or dementia.
Those decisions may include:
- Consent or refusal of medical treatment
- Choosing medical personnel – doctors, therapists, etc.
- Admission and discharge from medical facilities – hospital, nursing home care, etc.
- Access to medical records
- End-of-life decisions, donation of organs
Choosing your medical power of attorney
It can be difficult to choose your healthcare proxy, especially when you have children who are all close to you and to each other. You don’t want feelings hurt, but you do want to choose one person to make the final decisions.
Choose someone who is available, lives nearby, and is levelheaded. You want someone who has similar views as yours and who will follow your wishes. If you want to be kept alive using all measures, then knowing you have chosen a loved one who holds that same belief could be comforting. But you should also choose someone who will not take the power upon himself or herself and exclude family members.
Whomever you choose, it is important to have at least two other people who are alternates. It is not uncommon for people to simply designate a spouse as power of attorney and then become widowed. Without an alternative person designated, you will be without a voice if something happens to you before you get to designate a new proxy.
For your own peace of mind and to ensure that your wishes are fulfilled, take the time to choose a medical power of attorney and two alternates, and make sure all your children and close relatives have a copy of this information. It will be a comfort to you and all your loved ones if the day comes when a medical power of attorney is needed.
