Dear Healthy Aging Readers,
April represents renewal – and the passing of time – with spring or “sprinter” upon us, our annual reckoning of taxes on April 15, and a date less well known, but equally important, National Health Care Decision Day on April 16. Well timed, it seems to me. Read on to see why this matters to you, your family, and community.
April on the Vineyard is also the time for most town meetings. I urge you to attend, support the causes you believe in (including funding for HAMV), and don’t forget to vote. It is still one of the most effective ways we can make our voices heard.
Happy spring,

Cindy Trish
Executive Director, HAMV

Advance Care Planning—Having Your Wishes Honored

by Abby Remer
To paraphrase Benjamin Franklin, the only certain things in life are death and taxes. As it happens, April 16th is National Health Care Decision Day and while planning for your eventual death may not be your idea of fun (nor are taxes), it actually is one of the best gifts you can do for yourself and your family so that you’re not faced with end-of-life dilemmas at a time that’s already full of stress. Your loved ones can’t act on your wishes unless they know what they are. So, it’s imperative to take a bit of time to have a conversation and complete a health care proxy form.
HAMV’s Advance Care Planning Coalition is working to raise awareness of the topic and to engage our community in participating in this campaign. Here on the Island, as of the fall of 2021, 28.6% of adults who have a medical record at MVH, age 65 and older, have health care proxies on file at Martha’s Vineyard Hospital. Our short-term goal is to get that to 50%, although ultimately up to 100%, which other communities have accomplished, and we want to achieve.
Simply put, advance care planning is the process by which anyone 18 years or older makes her or his wishes known about end-of-life care. The first step is to reflect on what matters most to you—what are your preferences should you face a serious illness? There is a great resource to guide this discussion at the Conversation Project ( Without the conversation, there can be confusion, conflict, and guilt for those around you.
Likewise, if you are someone’s health care proxy, you can make decisions for them with confidence. Healthy Aging chair Cynthia Doyle shared her experience about having a heart-to-heart with her father the night before he went into heart surgery where there was a risk of his having a stroke. She says, “We had this conversation about what if he couldn’t talk or feed himself. My dad said, ‘If I can’t function and speak to people or feed myself, unplug me.’ That was such a relief and so helpful. If something had happened in that operation, I wouldn’t have known what his wishes were.”
The simple document you fill out is called a Health Care Proxy in which you name someone you know and trust to make health care decisions for you if, for any reason and at any time, you become unable to make or communicate them yourself. The person doesn’t necessarily have to want to make the same decisions for themselves, but they must be willing to uphold your wishes.
Dr. Robert Laskowski, a community activist, retired physician, and health care administrator who was his mother’s health care proxy describes just such a situation: “My mom ended up getting Parkinson’s disease and wasn’t able to speak for herself. Her illness was pretty complicated. She had very strong feelings about being fed; she didn’t want to “starve to death.” That wasn’t my feeling. I wouldn’t want tube feeding if I were in that position. But my family knew what my mother wanted, and we honored her wishes.”
Making your wishes known ahead of time puts your whole family on the same page and can save a lot of strum and drum. Dr. Tim Guiney, affiliated with Mass General Hospital and Harvard Medical school, and the Paul Dudley White Distinguished Service Chair in Cardiology at Mass General Hospital stresses, “I think that advance care planning is essential for a number of reasons, not the least of which is to avoid family disputes as the death of a relative approaches. There was one family where the patient was estranged from his wife and living with his sister, a retired nurse who looked after his medical needs. The estranged wife appeared and there was a loud argument about where the patient should be cared for in his last days. This unseemly display could certainly have been avoided had there been a signed health care proxy with one or the other of these women designated as the person who speaks for the patient.”
Make a few copies of the Health Care Proxy form. Keep one for yourself in a place you can easily find it, definitely not in a safe deposit box, but somewhere accessible and obvious. Be sure to give your agent a copy. But it’s imperative to get it into your medical record. You can give it to your health care provider and, if you live here on the Vineyard, you can mail a copy to the Medical Records Department at the Hospital. Remember, your physician wants nothing more than to abide by your wishes, but if you are unable to communicate and there isn’t a health care proxy on file, she or he is required to take every measure possible. Help them help you.
Coalition member Maris Keating, Director of Senior Services at The Anchors (Council on Aging) in Edgartown, has been on a personal crusade to help her clients complete a health care proxy. Undoubtedly, part of her success has been due to the existing trusting relationship people already had with the Council on Aging. Keating shares, “I decided that for about five weeks I was going to ask anyone and everyone who came in for any reason if they had their health care proxy filled out. People were very open to it. On average, it took five to ten minutes. We always have two witnesses in the building, so that part was easy. I found a significant number of people didn’t know if the Hospital had a copy, so that was the missing link.”
Keating continued, “The click moment for most people was when I asked them to imagine they were in an emergency situation and medical personnel needed prompt access to their agent, who will they call?” One of the biggest pushbacks she discovered was that people thought their lawyer was in charge, when in fact, unless you’ve made your lawyer your health care agent—they aren’t.
Keating reflected, “Overall, it seemed like people had a really good understanding of the role of what an agent is. Since many had the experience of being an agent themselves for a parent or loved one, they welcomed the conversation recognizing that they now had to do this. A lot of touching conversations came out of this.”
Advance care planning has never been more important. Take the time to have a conversation with your loved ones and your health care partners to discuss your wishes for end-of-life care. And if you like, April 16th is National Health Care Decision Day; you got your taxes in so now’s a perfect time to check one more thing off your list of important tasks.
Visit our website to learn more and for links to Advance Care Planning documents and resources. Remember to keep a copy for yourself, give one to your healthcare proxy, and mail one to:
Martha’s Vineyard Hospital
Medical Records Department
P.O. Box 1477
Oak Bluffs, MA 02557
Phone: 508-957-9831
Contact Cindy Trish at or 508-693-7900 ext. 455
or visit to learn more
Martha's Vineyard Community Services
111 Edgartown Road
Vineyard Haven, MA 02568

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