Establishing Non-Family "Next Of Kin" Status

[bigeekgirl]

I've made a decision today to seek legal status for my best friend to be the one in charge of handling my care in the event I or my husband cannot do so. In my research, the term "living will" has come up along with "health care power of attorney." I haven't read the fine print yet since this conclusion could only have been made on a "bad brain day" like today, but both my husband and my best friend agree with my reasons. When I asked my friend, she simply said, "I always considered myself your next of kin anyway."

While part of me feels like this measure is rather drastic, I have a specific event in my not-so-distant past which makes my terror at my parent's having control over my care a realistic fear. I would love to know if anyone has experience with doing something like this. My concern isn't "end of life" situations, but rather mental health crisis where I am deemed by medical or legal establishment not be be able to make decisions for myself. I had my parents in charge before and I felt nothing but railroaded by how they swooped in to "help" and the hospital had no choice by to listen to my "next of kin."

In 2010, I was hospitalized for "brief reactive physios" and while I made the 911 call after days of being nearly constantly without eating properly, a judge signed an order putting me in a locked ward for a full week. My now-ex-husband had left, I was unemployed, lived in the middle of the country near my best friend with one set of parents on each coast. You know, for a reason, and I fucking fell apart because my whole identity was being a hard worker and a wife. It wasn't very rewarding and I wasn't happy but, by golly, I sacrificed to do the right thing.

It was a turning point in my life and I am so grateful it happened. My statement goes equally for the physios itself as well as my hospital stay. It was hard and humbling. I learned so much and nothing more important than it was not the worst possible thing for me to loose my grip. After was hard, but not any harder than before and far more hopeful.

What happened after my hospital stay was not so lovely. Within 48 hours, as planned by the social worker at the hospital who I don't actually remember meeting, was that my father and step-mother flew in, picked me up at my best friend's house and flew with me to the other coast where I was to stay with my mom and step-dad as I recovered and rebuilt. The very home I'd fled at age nineteen to be with a wholly unsuitable man I eventually married and had moved away from the area with almost a decade before with no intention of returning. But no one will listen to the girl who just got out of what my bio-dad referred to as the "nut house" and any frustration I showed could be written off as a result of the mental illness. My best friend was equally frustrated the hospital would not listen to anything she had to say. Not only did I choose to live a handful miles from her and a few thousand from any blood relations, she was with me as much as possible in the weeks prior to my hospitalization. She saw what happened first hand.

It took me six months to get away again. I moved to where my ex had gone even though I was 85% sure I wasn't getting back together with him. I got divorced. I got a job. I started building a life for myself. I didn't know exactly how it would turn out, but I knew there was no turning back.

Lately with the anxiety I've been struggling growing so strong, I've begun to think about how dangerous it feels to be one or two traumatic events away from ending up on a plane "home" with a therapist and a social worker and even a judge all concluding after phone calls with my mother who everyone thinks is so *nice* that I need to be in the care of my "family" without any knowledge to who I regard as my family. I live about 800 miles from my best friend now so depending on the circumstance she might even have trouble getting to me, but my parents didn't set foot in the hospital to end up in charge of my life when I couldn't speak for myself.

My life is good. I am working to get healthy. I trust my husband to care for me if I suddenly found myself too out of my mind to do it for myself. What I can't possibly leave up to fate is what would happen to me if something happened to him. While I believe our relationship is strong and I feel secure he's not going anywhere willingly, I can't imagine anything more likely to land me back in a mental hospital than loosing him in any of nearly infinite ways one can loose another person. Bluntly, if he got hit by a bus tomorrow - as if we had mass transit enough to be a risk here in SC - I can't imagine NOT ending up in the hospital at some point in my grieving process. I hope someday to be healthy enough not to feel that way, but with the history I have, I know it's not an abstract idea. It's a real possibility. Being sick doesn't scare me. Going to the hospital doesn't scare me. I'm strong enough for both of those things. What fucking terrifies me is the idea of ending up in my parent's tiny apartment reliving the traumas of my childhood one more time. I told my husband today, I'd be homeless first. Now, I have several options for warm and safe places before that would be a reality, but I will not go back there for more than a brief visit EVER. Hell, I've been ignoring phone calls for months.

One must have boundaries and it looks like I'm drawing some of mine up on LegalZoom.

[bigeekgirl]

Holy crap! I always seem two write three times as much as I intended.

[manuel_moe_g]

More power to you. Your story is compelling. You have impeccable judgement. Rock on, bigeekgirl!

[bigeekgirl]

Thank you.

[meh]

Get a lawyer and get it in writing. Your husband is technically and legally your next of kin. After that, a lawyer should know what you need to do to ensure your friend is in the line of succession.

[bigeekgirl]

That's the plan. It's funny to think I'll feel more stable and less likely to need to use it once I have it all legal.

[Data]

First of all thank you for sharing this! I work in a hospital, as a secretary really, but I see my fair share of advanced directives. Establishing an advanced directive is something everyone should really do, but even more so if you have any chronic medical conditions, been hospitalized, or are planning on undergoing surgery.

In general the difference between an "Advanced Directive" and a "Living Will" is that an advanced directive commonly designates who your power of attorney is and the extent that he/she can make healthcare decisions for you in the event that you are unable to make decisions on your own behalf. This can only been enacted with the signature of an attending physician. A living will entails the continuation or end of life sustaining treatment if you are near death or unable to physically sustain yourself. A durable healthcare power of attorney will allow your agent to have access to your medical records and a part in your treatment planning. Put all of these together and your agent would actually have MORE rights than your next of kin would have without an Advanced Directive. For example a next of kin doesn't have the ability to request your medical records under federal hippa guidelines, your DPOA (durable power of attorney) could have automatic access to these if you chose to include that.

What exactly is entailed in each of these forms and how they will be enacted depends on your state, so if you wanted a general advanced directive I would say contact your local county court house and they would be able to supply you with a general advanced directive packet you could do at your kitchen table. However, a mental health advanced directive is a little more complicated because the definition of "incapable of making healthcare related decisions" gets a little harry, and you may not want all the bells and whistles that are built into advanced directives for those who are near the end of life. It does sound from what you have said that an advanced directive is something you definitely want though. I would highly suggest contacting a lawyer who specializes in advanced directives for this purpose.

I'm free to answer any questions, but like I said earlier I am no specialist in this just have a sliver of experience and I thought I would share in case it is of any help.

[Cinnamon]

Many states, including Colorado and Illinois, make standard forms available and there are sites that go into detail about what specifics you can add or subtract based on your preferences.
Name 3 in order, not all at once, but successive as in an emergency, there is often someone hard to reach.
Be clear on concepts (If I never walk again) rather than treatments which change over time
get the document notarized for ease of acceptance.
Having an attorney is not always required to make a valid document that is legal but if you have complicated questions then you should use one.
and you can personalize these, so you make it valid forever or for 6 months, for mental health only, etc.

See here for guidelines:
http://www.illinois.gov/aging/Protectio ... thcare.pdf
and here as well
http://www.ilga.gov/legislation/ilcs/il ... &SeqEnd=-1
http://www.coloradoadvancedirectives.com/MDPOA_form.pdf

and sometimes it is easier not to name a spouse. My sister is married to a doctor but her best friend - a nurse - is hers because she feels there is less emotional impact on the person making the decision.