Kelly Gustafson, MCHC Social Worker

Advance Directives and POAs: How To Ensure Your Healthcare Wishes Are Honored

21 Apr 2025 Uncategorized ,

April 16th was National Healthcare Decisions Day — a day set aside to focus on advance care planning and making sure your healthcare choices are known. 

Advance care planning includes having conversations with your loved ones, as well as taking care of some paperwork, including completing an advance directive and appointing a healthcare power of attorney (POA). These actions help you prepare for future medical decisions should you become seriously ill or be unable to communicate your care preferences.

When you have a carefully considered plan in place, you’re more likely to get the care you want when you need it. So consider this your invitation to learn more about advance directives and POAs to ensure you are prepared.

What Is an Advance Directive?

An advance directive (sometimes known as a living will) is a legal document that specifies your healthcare preferences in the event you become unable to communicate your wishes or make decisions for yourself. This document outlines your medical care instructions in detail, and can be tailored to specific situations. 

For example, your advance directive provisions could include items like:

  • “I do not want to be kept alive by artificial means, such as a ventilator or feeding tube, if I have a terminal illness and there is no reasonable expectation of recovery.” 
  • “I want to receive all necessary medical treatments to prolong my life, unless I am in a persistent vegetative state and have no hope of regaining consciousness.” 
  • “I do not want to be resuscitated if my heart stops or I stop breathing.” 
  • “I want to be resuscitated only if there is a reasonable chance of survival with a good quality of life.” 
  • “I do not want to be intubated or placed on a ventilator.” 
  • “I want to receive pain medication and other comfort measures, even if they shorten my life.”
  • “If possible, I want to donate my organs after my death.” 

These are only examples — the wording and provisions in an advance directive will vary depending on your individual circumstances and the laws of your state.

What Is a Healthcare Power of Attorney?

A healthcare power of attorney (POA), is also known as a “durable power of attorney,” and may have a different name depending on the state you live in. It is a legal document that allows you to appoint someone as your healthcare “proxy.” Your healthcare proxy is someone who can make healthcare decisions for you if you aren’t able to communicate your wishes or make decisions yourself. 

This is another option to ensure your medical treatment preferences are respected, even if you aren’t able to communicate them. A POA can be used either in addition to or instead of an advance directive.

The person you choose as your healthcare proxy should be someone you trust who is familiar with your personal values and wishes. They will be able to make decisions for your medical care, including:

  • Consenting to or refusing medical treatments 
  • Choosing healthcare providers and facilities 
  • Authorizing pain relief 
  • Accessing your medical records 
  • Authorizing life-sustaining care, such as a feeding tube or ventilator 

Note that a healthcare POA is different and separate from a standard POA. Where a standard POA is generally focused on financial and legal matters, a healthcare POA is focused on medical decisions. These documents are separated because medical decisions are highly personal and require a specific legal framework that differs from that for a standard POA. 

Additional Considerations for Advance Directives and POAs

Without an advance directive or POA, the state laws where you live will determine who can make medical decisions on your behalf (typically a spouse, parents, or adult children).

It’s important to note that advance directives and POAs are not only for the elderly or those who are already ill. A medical crisis can happen at any age and leave you unable to communicate your healthcare wishes. It’s important to make a plan now to ensure you get the medical care you want when you need it, and that someone you trust will be there to make decisions for you if you are unable to do so yourself.

A few other things to keep in mind when completing your advance directive and/or POA:

  • You must be mentally competent to complete these documents.
  • Consult with a healthcare professional and/or an attorney to ensure your advance directive and healthcare POA are legally valid and will result in your desired outcomes. 
  • Discuss your wishes with the person you choose as your healthcare proxy for your POA to ensure they understand your medical care preferences.
  • Store both documents in a safe, but easily accessible, location. 
  • Distribute copies of your advance directive to your healthcare providers, family members, and close friends.
  • Make sure your healthcare providers, attorney, and your chosen healthcare proxy have copies of your POA.
  • Review your advanced directive and healthcare POA once per year and/or when a major life event occurs, such as retirement, moving to a different state, or significant changes to your health.

Questions regarding these documents? Reach out to your doctor or attorney to discuss any medical or legal questions you have.

This National Healthcare Decisions Day, the team at MCHC encourages you to fill out your advance directive and/or create a healthcare POA to ensure your healthcare wishes are honored.

Helmsley Charitable Trust Grants $238,556.00 to Help Mountrail County Medical Center Purchase State-of-the-Art Ultrasound Equipment

7 Mar 2025 News, Rural Healthcare , , ,

Stanley, ND — The Leona M. and Harry B. Helmsley Charitable Trust has granted $238,556.00 to Mountrail County Medical Center to purchase a Mindray TE X ultrasound system for the ER and a GE Logiq E10s for the Radiology Department as part of a $27.4 million ultrasound initiative in North Dakota.

The initiative includes more than $21.8 million to help 69 North Dakota hospitals and health centers purchase ultrasound imaging devices and nearly $5.7 million to boost sonography and point of care ultrasound (POCUS) training opportunities across the state.

“The Helmsley Foundation has provided the ability for our radiology department to bring more advanced ultrasound services to Mountrail County and our neighboring communities”, explains Brenna Williams, Radiology Manager for MCMC.  “Our new machine will provide higher quality echocardiograms and more detailed imaging in pre-natal and breast exams along with general, vascular, and pediatric ultrasonography.  The generosity of the Helmsley Foundation will play a key role in achieving superior diagnostic imaging and setting the standard for exceptional rural health care.  Ultrasound uses high-frequency sound waves to produce images of structures inside the body. This safe, cost-effective tool supports other clinical information to help providers make timely diagnoses and provide appropriate treatment.”

Walter Panzirer, a Trustee of the Helmsley Charitable Trust, said the grants will help improve access to top-notch medical treatment for North Dakotans, whether they live in Fargo, Bismarck, or Grand Forks, or a smaller rural community such as Bottineau, Rugby, or Hettinger.

“These grants will help ensure that hospitals and health centers across North Dakota have the latest in state-of-the-art ultrasound equipment and training,” Panzirer said. “Facilities need to stay current with rapidly advancing technology so they can continue to provide the very best healthcare close to home.” 

The majority (134) of the devices purchased through the grants are POCUS machines, which are used by providers at the bed or tableside for immediate assessment of a patient to quickly determine a course of action. The grants will also provide 57 general ultrasound systems and 24 cardiovascular ultrasound systems, which aid in imaging of the heart.

“The Helmsley grant has allowed us the ability to update our point of care ultrasound system to provide further advanced technology to the Mountrail County Medical Center bedside,” states Brittany Haugtvedt, MCMC’s ER DON.  “The new ultrasound system offers a full suite of innovative features and AI powered Smart Tools to help expedite clinical decision making.  We are very grateful to the Helmsley Foundation for allowing us to have the best-in-class imaging to help provide a higher standard of care in the rural health care setting.”

The initiative also includes nearly $1.9 million to North Dakota State University and nearly $3.8 million to High Quality Medical Education (HQMEDED) to expand sonographer expertise and provide comprehensive POCUS training to doctors, physician assistants, and nurse practitioners. Additionally, more than $64,000 will go to individual facilities to boost sonographer training.

The Helmsley Charitable Trust has committed a total of $72 million to fund ultrasound equipment and training initiatives for rural communities and underserved populations in Nevada, North Dakota, Minnesota, and Wyoming.

(Additional information including photos and b-roll video can be downloaded from https://helmsleytrust.box.com/s/prhpsbah1ldnd5cun4lcyehhw5474zo9)

About the Helmsley Charitable Trust

The Leona M. and Harry B. Helmsley Charitable Trust aspires to improve lives by supporting exceptional efforts in the U.S. and around the world in health and select place-based initiatives. Since beginning active grantmaking in 2008, Helmsley has committed more than $4.5 billion for a wide range of charitable purposes. Helmsley’s Rural Healthcare Program funds innovative projects that use information technologies to connect rural patients to emergency medical care, bring the latest medical therapies to patients in remote areas, and provide state-of-the-art training for rural hospitals and EMS personnel. To date, this program has awarded more than $750 million to organizations and initiatives in the states of Hawaii, Iowa, Minnesota, Montana, Nebraska, Nevada, North Dakota, South Dakota, Wyoming, and two U.S. Pacific territories, American Samoa and the Commonwealth of the Northern Mariana Islands. For more information, visit www.helmsleytrust.org.

National Rural Health Day 2024: MCHC Staff on the Power of Rural Healthcare

22 Nov 2024 Events, Rural Healthcare, Uncategorized , , , ,

Created in 2011 by the National Organization of State Offices of Rural Health (NOSORH), National Rural Health Day is an annual celebration of rural healthcare providers and other organizations dedicated to addressing the unique healthcare needs of rural communities. 

With dozens of webinars and other events highlighting various aspects of rural healthcare, National Rural Health Day helps healthcare providers, community partners, and individuals celebrate the healthcare wins and address the struggles of their communities.

This year’s National Rural Health Day was on Thursday, November 21st. To celebrate at MCHC, we asked some of our long-term staff what they think is the power of rural healthcare. Here’s what they had to say.

An Interview With MCHC Staff: The Power of Rural Healthcare

Jim Clark—Director of Plant & Maintenance, 37 Years of Experience

What do you love about working in rural healthcare?

I love working in rural healthcare because I love providing for a community that I have been part of for most of my life. 

What would you say to a college graduate about why they should consider working in rural instead of urban healthcare?

I would ask them if they like living in a small community and getting to know the people they work with. There is more of a personal touch in the small communities. 

What do you think is the biggest challenge facing rural healthcare today?

The biggest challenge facing rural healthcare is staffing shortages, as well as finding quality employees. 

What traits does someone need to have to work in rural healthcare?

You have to be willing to step up and be able to work in many different departments and wear many different hats.

Pat Aho—Dietary Services, 34 Years of Service

What do you love about working in rural healthcare?

It gives me the chance to help people when they are in the most vulnerable time of their life. 

What would you say to a college graduate about why they should consider working in rural instead of urban healthcare?

You have a chance to get to know the people you work with versus in urban healthcare you see so many people, you don’t get the same closeness. 

What do you think is the biggest challenge facing rural healthcare today?

I think smaller communities have a harder time keeping up with the benefits they can offer compared to urban areas. Urban areas have more resources and can offer employees more pay and better benefits.

What traits does someone need to have to work in rural healthcare?

I think someone in rural healthcare needs to be compassionate and understanding of people’s wants and needs.

LaDonna Kinnoin—Purchasing/CSR, 35 Years of Experience

What do you love about working in rural healthcare?

I love taking care of people and being able to provide what they need so they do not have to travel so far to get the care they need. 

What would you say to a college graduate about why they should consider working in rural instead of urban healthcare?

I would tell them that it is very rewarding.

What do you think is the biggest challenge facing rural healthcare today?

In my job, it’s the cost of supplies. Because we are a smaller facility, we do not get some of the discounts offered when you buy in bulk.

What traits does someone need to have to work in rural healthcare?

Someone working in rural healthcare needs to be friendly, kind, and want to help others.

Janel Borud, RN—Clinic Director, 27 Years of Experience 

What do you love about working in rural healthcare?

I love working in rural healthcare because I get to know our patients more intimately due to our smaller population. I have assisted in caring for the same patients from birth to adulthood and cared for their parents and grandparents. It is a sense of community. 

What would you say to a college graduate about why they should consider working in rural instead of urban healthcare?

There are plenty of loan repayment/forgiveness options when working in a rural area. Also, due to the deficit of healthcare workers in rural areas, facilities work hard to incentivize those open positions. Help in relocating may also be part of the incentive package. Being rural also means specialists are few and far between, giving you the opportunity to see a wider scope of patients and gaining a great deal of experience. 

What do you think is the biggest challenge facing rural healthcare today?

Lack of healthcare workers, increased cost of delivering care, insurance companies not paying enough for the cost of care for patients, and the inability of the patients to pay their share of the high treatment cost. I don’t think this is only an issue within rural healthcare, as healthcare facilities in urban areas are seeing this as well.

What traits does someone need to have to work in rural healthcare?

They need to enjoy a slower pace of life, be adaptable and versatile, enjoy community, and have a team player mentality.

Taina Karow, RN — 39 years of experience

What do you love about working in rural healthcare?

I love rural healthcare because it is extremely rewarding to me to do what I love in such a wonderful community of people who I have come to know and love, with genuine concern for their wellbeing. 

What would you say to a college graduate about why they should consider working in rural instead of urban healthcare?

It is the heartfelt care I want to give our patients, always knowing that I am caring for someone’s loved one as I would my own. This comes easily because of the interpersonal relationships that develop in a rural community. 

I am also thankful and honored to work in a rural hospital, as a team player who cares about others and works together for the common good of our patients. Each day we have an opportunity to make a difference in someone’s life. That is the beauty of community and rural health. For the small things I do, it comes back to me tenfold. 

Please join us in thanking the entire MCHC team for their dedicated work throughout the year to ensure our community has the quality healthcare they need to thrive. Together, we’ll continue to build a healthy community for many years to come.

Looking for a career in rural healthcare? MCHC is hiring! Check out our careers page for open positions.

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