Protecting Your Choices
Health care proxies, which are also know as a (durable) power of attorney for healthcare, help protect your wishes when you aren't able to make them for yourself. It's vital to have so that your family and friends know what your decisions are and don't have to waste valuable time, and money as others decide your health care choices for you.
What is a Power of Attorney for Health Care or Health Care Proxy
What is a power of attorney for health care, (sometimes called a health care proxy or advance directive)?
It is a document that gives someone else the authority to make health care decisions for you if you are unable to make and/or communicate such decisions. A power of attorney for health care or advance directives allow you to decide who you want to be in charge of your medical treatment and in some cases, how you want to be treated.
What is an “invoked power of attorney for health care”?
It is a power of attorney for health care that has been activated.
“Invoked” means to activate. Your primary care doctor, the courts, or the hospital team can invoke your power of attorney for health care, again meaning that it will be activated and your wishes that you declared will be enacted.
What are advance directives?
An advance directive, simply stated, is a document that you complete directing what you want to happen in regards to your medical treatment if you become incapacitated. A power of attorney for health care is a type of advanced directive because you are naming someone to act on your behalf in the future if you cannot make health care decisions. Usually, however, when advanced directives are being discussed, it means that a person has written specific instructions for his/her doctor about what life sustaining treatment he/she wants.
Is a health care proxy the same
as a power of attorney
for health care?
Basically, yes. It is confusing because in the United States we do not have a uniform law and a uniform name for the document which enables a competent adult (principal) to designate a person (agent) to make health care decisions for the principal in the event that he/she is unable to make and/or communicate decisions about medical treatment. For instance, in Massachusetts you appoint a Massachusetts health care proxy, but in Florida that person would be called a "health care surrogate". In other states, like Missouri, that person would be a durable power of attorney for health care.
It is important to note that generally there are two types of powers of attorney: one is strictly for health care decisions and the other is for money decisions. Here, we are only talking about powers of attorney for health care.
What is the difference between a living will and a power of attorney for health care?
A power of attorney for health care designates another person to make medical decisions if you cannot do so. A living will allows you to list medical treatments and/or end of life decisions that you would or would not want if you became terminally ill and/or unable to make your own decisions. Some treatments considered by a living will include artificial nutrition and hydration, ventilation or CPR. These documents are often very specific in what types of situations and applications of care to which they apply.
Most states, but not all (for example Massachusetts), consider living wills valid and enforceable.
Why might you need a health care proxy?
If you are medically unable to communicate your wishes about treatment, healthcare workers must legally assume that you desire to live and thus treat you to the fullest extent deemed medically necessary. If your wishes differ from this, your loved ones would be forced to appeal to the courts to change your course of care if you don’t have a health care proxy named. This is costly and puts enormous strain on your family as they wander through the court system asking for permission to extoll what might be your wishes and who you might want to make those decisions.
Everyone over the age of 18 should have a health care proxy, especially those with pre-existing health conditions.
Can a health care proxy cover mental health issues?
In general, a standard health care proxy/medical power of attorney does not grant your agent authority regarding mental health treatment.
Some states’ laws have allowed a person to designate an agent for mental health treatment. Those states such as New Mexico and Hawaii for example, allow a person to give detailed instructions about mental health treatment and/or allow a designated agent to make decisions. If you would like your agent to make decisions regarding mental health treatment or have specific wishes, you should still document it. It could be used as evidence in a court proceeding.
More about organ donations
Each state allows adults to make a decision about if he/she wants to be an organ donor; and if so, what organs he/she wants to donate and in what circumstances. These are personal decisions that require reflection and discussion. There is no right or wrong decision in terms of deciding if you want to donate your organs, which organs you would like to donate or to whom. It is simply what you are comfortable with doing. Be sure to discuss your decision with your health care proxy and other loved ones.
What are life sustaining treatments?
In general, life sustaining treatments are medical treatments that would extend your life such as Cardio Pulmonary Resuscitation (CPR); artificial hydration and nutrition and mechanical ventilation. It does not include any treatment that provides comfort or reduces pain, which would still be administered even if you choose not to have life-sustaining treatment.
What is a 'Do Not Resuscitate' order or DNR?
A ‘Do Not Resuscitate’ or “DNR” order is a legal form that allows you (the principal) to authorize medical providers to withhold cardiopulmonary resuscitation (CPR) or other life-saving treatments if your heart stops or you were to stop breathing. If your heart stops, medical personnel will not seek to revive you.
Who Needs a Health Care Proxy
Who needs a power of attorney for health care?
Every adult needs a power of attorney for health care.
No one can predict the future, but you can prepare for it. A completed power of attorney for health care enables you to be in control and appoint someone to act on your behalf if you are unable to make and/or communicate health care decisions.
When should I get a power of attorney for health care?
Whether your 19 or 99, we don’t know when emergencies might occur, so it’s never too early to start planning.
When is it too late to fill out a health care proxy?
If you become incapacitated or no longer mentally capable of making decisions, a health care proxy cannot be completed. If you have no health care proxy and become incapacitated, a legal court process becomes necessary and your personal decisions are now in the control of lawyers and judges.
How Do I Use a Health Care Proxy
When is a health care proxy used?
Health care proxies become most important when you can’t make decisions on your own, for example when you’re unconscious or if you’ve lost your mental capabilities. They only become effective when you are no longer are able to make decisions or you cannot communicate for yourself.
When does your health care proxy become active?
Your health care proxy doesn't go into effect until your doctor certifies in writing that you are “unable to make or communicate your own healthcare decisions.” If your doctor later determines you have regained the ability to make your own health care decisions, the health care agent’s authority to make decisions for you ends.
Should I list explicit exceptions?
Instead of listing explicit exceptions, choose someone that you trust who will make decisions closest to ones that you would want made. It is often difficult to anticipate what situations might be faced and explicit exceptions will often cause confusion, delays in decision making and other unintended consequences.
How Do I Choose a Health Care Proxy
Who should I choose as my health care proxy?
A health care proxy is someone who you trust to know and communicate your wishes.
Think about who in your life you trust and know well enough to have this person make decisions for you when you can’t. Will this person be able to make life or death decisions for you and honor your wishes? Could the burden of making these decisions be too much? The person that you choose should be able to make decisions and clearly communicate those decisions. Also, note that whoever you choose will be given access to all of your medical records and health information.
It is also smart to choose a person close to where you live or someone that will be able to come to the location of where you are. Your health care proxy must be 18 or over (check your state’s requirements) and legally competent. It is important to note that a health care proxy does not make financial decisions, only decisions related to health care.
Do I need an alternate health care proxy?
While it’s not required to name an alternate, you should name an alternate health care proxy in case your first choice becomes unavailable.
Can you change who you named as your health care proxy?
Yes. If your health care proxy otherwise known as a power of attorney for health care needs to change, simply fill out a new health care proxy form, have it executed, save it and share it.
This most recent health care proxy executed is legally held valid, provided you had capacity when you completed it. Revoke your previous health care proxy in writing by telling your health care agent, your alternate, your doctor, your nurse or your lawyer that you are revoking it; or by doing anything that clearly shows you no longer intend the previous health care proxy to have effect.
How often should I update my health care proxy?
Review your health care proxy regularly.
We at Gentreo recommend once per year to make sure the names, addresses and telephone numbers of your health care agent and alternate are current, and that your health care agent and alternate are still willing to serve.
Who to tell about your health care proxy
Once you complete your health care proxy, it’s important that your agent, doctor and loved ones know that you have it completed and where it is stored.
It’s extremely important that not only do they know that you have it, but they can get access to it in a timely manner. If you go to the hospital, take a copy of the health care proxy with you or give your representatives access to your Gentreo file so they can provide the hospital with a copy of your health care proxy.
Additionally, you may want to grant access to your health care proxy to your family, lawyer, clergy or friends. Never keep a health care proxy in a safe deposit box as this makes it impossible to retrieve. Instead, keep it safe in your Gentreo Digital Vault.
More About Health Care Proxies
Can I use my power of attorney for health care in a different state if I live in more than one state?
As long as your home state’s power of attorney for health care satisfies the laws of the other state, it will be valid.
If you spend time in multiple states, it is recommended that you have a power of attorney for health care for each state. Gentreo is working to make a form that works for you in all 50 states as most states do not require a specific form, but rather that your form is witnessed by the correct number of witnesses who are of a valid age per that state. If you have a Texas directive to physicians and family or surrogates it is not necessarily the same as a Virginia advance directive for health care. But, if you have a power of attorney for health care or health care advance directive, it is most often applicable in other states.
In some instances, the state in which you did not create the power of attorney for health care or advance directive may limit what your form can do, if what you want to do is not legal in that state.
What if I have additional instructions for my agent?
It is helpful for your health care agent to know what you would want so that he/she can make the right decision for you.
Please detail any additional specific instructions you may have about your health care on your health care proxy form. Hopefully, you have taken the time to select an appropriate health care agent who knows you best and who you trust to make the right decision for you.
Are there any additional documents in regards to health care decisions?
Yes. Some states allow you to create a living will. Also, most states have a type of “OLST” form, Orders for Life Sustaining Treatment. These forms are for individuals who are diagnosed with a life-threatening disease.
As a member of Gentreo, we'll help you find and prepare what documents are right for you based on your state.
What do you do with a completed form?
Once your form is completed, it should be stored your the Gentreo Digital Vault, which allows you to give access to specific family and/or friends. A copy should also be given to your doctor(s).
Does anything cause a health care proxy to be automatically revoked?
Your health care proxy is automatically revoked if you complete a new health care proxy form (including having it notarized if needed in your state), or if you legally separate from or divorce a spouse who was named as your health care agent. This means you must create a new health care proxy for one to be valid in these cases.
Unless you revoke your health care proxy or it is revoked automatically, it remains in effect until you die.