Green Sleeves important part of advance-care planning, seniors told

By Lethbridge Herald on June 8, 2024.

Kimberly Wescott, seniors healthcare nurse, and Lethbridge lawyer Austyn Anderson, share information about advanced care planning during the Lethbridge Senior Citizens Organization annual Live Well Showcase Friday. Herald photo by Delon Shurtz

Delon Shurtz – LETHBRIDGE HERALD – dshurtz@lethbridgeherald.com

What’s on the outside of a fridge may be just as important as what’s inside.

Although a calendar and assorted magnets with pictures of children and grandchildren typically cover many family refrigerators,  there’s one other item that should be stuck to the fridge, at least in a senior’s home.

It’s called a Green Sleeve.

A Green Sleeve is a plastic pocket – like a medical passport – that holds important advance-care planning documents. It’s recognized by Alberta Health Services healthcare providers, so that in an emergency, medical professionals will have access to personalized advance-care plans and understand the healthcare wishes of the person for whom the Green Sleeve is intended.

Green Sleeves don’t belong in a closet or in a drawer under the socks, but firmly attached to the fridge, or at least near the fridge in case of an emergency and it needs to quickly be retrieved by a medical professional, such as a paramedic.

“The reason we tell them to put it on their fridge, is EMS is actually trained to go to the fridge and look for the Green Sleeve,” says Kimberly Wescott, an Alberta Health Care nurse in seniors’ health and home care.

Westcott and Lethbridge lawyer Austyn Anderson presented a session on advanced care planning during a Live Well Showcase Friday at the Lethbridge Senior Citizens Organization. 

While Westcott addressed health-related aspects of advanced care planning, Anderson discussed the legal side of it, including personal directives, or living will, and enduring power of attorney.

Westcott said it’s critical seniors not only plan their advanced care, but discuss it with family members so they know exactly what is to happen when an elderly loved-one faces death or loses capacity to decide what happens. And it’s critical the plan is contained within the Green Sleeve.

“It is every healthcare provider’s best friend,” Westcott said. “We love these things.”

The Green Sleeve should contain a supportive decision maker document, a goals of care order, an updated medication list, a list of current medical conditions, family contact information, copy of a personal directive and a copy of enduring power of attorney.

A supportive decision maker document allows a person to designate someone to help make decisions. A goal of care sets out how aggressive care should be to keep a patient alive. It could include intubation, chest compressions, surgery, medications, comfort care, terminal care or a combination of care. Or perhaps just care up to a certain point, but not beyond.

Westcott pointed out there are some specific risks and consequences associated with some of the care provided, such as chest compressions following a heart attack.

“It is not pretty, it is not nice, and often we break your ribs,” she said.

On the legal side of care, Anderson said personal directives and enduring power of attorney are also crucial documents to ensure a patient’s wishes are met.

“The ambulance comes, everybody’s frantic, we’re trying to get a hold of kids, we’re trying to get a hold of whoever, and we’re scrambling,” Anderson said. 

“That’s why these documents that I’ll be discussing are so crucially important today.”

A personal directive, or living will, involves any personal or health-related matter not related to a person’s finances, which is covered by the power of attorney.

“We’re talking about your healthcare and your personal matters when you no longer have capacity. This cannot include instructions related to suicide, medical assistance in dying or MAID, euthanasia or other instructions prohibited by law.”

MAID, medical assistance in dying, can only be requested by a person who has capacity and fully understands the process, unlike other circumstances where a person who does not have capacity can have an agent make decisions. An agent cannot request MAID for another person.

“A person must have capacity in order to access MAID,” Westcott said. “You cannot designate anybody, you cannot have anybody act on your behalf. It has to be you from start to finish.”

Anderson said a personal directive can include instructions for healthcare, accommodations, with whom a person associates, participation in social activities, and education. So it’s important to get the right person.

“We want to focus on who we choose, on somebody who we trust. For most people that is going to be their children, it could be their best friend, it could be their cousin, somebody that you know is going to act in your best interest.

Enduring power of attorney gives authority for someone to help with financial matters, such as paying bills, investing money, dealing with an estate, selling a house, helping with business finances, or applying for financial assistance.

Although lawyers are not always necessary in the process, Anderson said some banks require a lawyer to draw up a power of attorney.

“Why is that? There are tremendous frauds that are happening throughout our country and the world today. I’m sure each one of you has had somebody call your phone pretending to be somebody you know, trying to get access to your account.

“It might be annoying to you that the banks are saying, oh no, go to Austyn or go to another lawyer and get a power of attorney, but they’re doing it to protect you, they’re doing to make sure that A: you have the capacity, and B: these are actually the people you want touching your bank account.”