It is fairly common to have some confusion regarding what a health care proxy is and how it fits into advance planning. Much of the misunderstanding arises from the fact that different states use different names to describe the same document. Other terms to describe the same intent as health care proxy include terms such as healthcare surrogate, durable medical health care power of attorney, or healthcare agent.
Jump ahead to these sections:
- Definition of Health Care Proxy (Agent)
- Who Typically Needs a Health Care Proxy?
- What Are The Responsibilities of a Health Care Proxy?
- How Do You Appoint a Health Care Proxy?
- When Does a Health Care Proxy Take Effect?
Regardless of what term or form your state uses, the value of designating a health care proxy cannot be overstated. You may be reluctant to set up a health care proxy, and that is normal, especially if you do not understand the flexibility of the form, know who to designate and whether you need it now or later.
All those reasons aside, the fact remains that the sooner you complete a healthcare proxy form, the better. Then you can put your mind at ease that you have someone you trust to carry out your health care wishes. Designating a health care proxy should be part of the advance planning process.
Definition of Health Care Proxy (Agent)
A health care proxy is a person you legally designate to make healthcare decisions on your behalf if you cannot communicate your wishes. The health care proxy has the same rights as a patient to request or refuse treatment, especially if the patient is unable to make and communicate their own decisions. In other words, the health care proxy stands in the shoes of the person that appointed them to make decisions.
What does it do?
A health care proxy springs into action if you become incapacitated or are unable to voice your wishes. That is why it is crucial for you to consider the conditions under which specific medical interventions can be used. Remember, you are not able to make these decisions. The more specific you can be, the better to guide your health care proxy in making the best decisions regarding your care.
How does a health care proxy fit in with other advance directives?
This is where things can get a bit complicated. The term advance directives describe all of the documents you need should you become unable to carry out or make decisions on your behalf. Advance directives apply to healthcare and financial decisions. Here are the other documents that you need to complete your advance directives.
A living will
A living will gives specific information about the procedures you would want—or would not want—to be performed if you become terminally ill. A living will is more narrow in scope than a health care proxy in that there are specific circumstances under which the living will take effect. Your health care proxy cannot overrule decisions that you have made in your living will.
A power of attorney or durable power of attorney
A power of attorney or durable power of attorney authorizes the person you designate to make financial decisions for you. You cannot use a power of attorney to make health care decisions, however. You must complete a health care proxy for that purpose. In some states, the phrase “health care power of attorney” will clarify that the term is for the express purpose of healthcare decisions.
You can use some health care proxy forms to specify that your organ and or tissues be used for transplantation, research, or educational purposes.
How is a health care proxy different from a power of attorney?
A power of attorney is a document that permits you to appoint a person or organization to manage your property, financial, or medical affairs if you can’t. For example, in real estate transactions, you can grant temporary power of attorney to a person to sign legal documents if you are unable to do so.
A general power of attorney gives broad authority to a person or persons to make decisions. These powers could include handling financial and business transactions, buying real estate or insurance, operating a business, or entering other legal agreements as designated by the grantor.
However, all POAs are not equal. Each type gives your attorney-in-fact—the person who will be making decisions on your behalf—varying levels of control. You may have a different person as financial power of attorney and another one for health care proxy or health care power of attorney.
Who Typically Needs a Health Care Proxy?
Anyone over the age of 18 needs a health care proxy, but urgency grows with age since more is likely to happen the older you get. If you wait too long and haven’t designated someone and you become ill and unable to make decisions, your healthcare team will do everything they can to treat you.
Younger people also have accidents or unexpected illnesses. Designating a health care proxy will ensure that someone follows their wishes. A younger person may want more aggressive interventions than someone older and less willing or able to endure invasive life-saving treatments.
What Are The Responsibilities of a Health Care Proxy?
A health care proxy has great legal and ethical responsibilities. Discussing the nature of these responsibilities with your potential health care proxy will help prepare them for the significance of the role.
Be as specific as you can regarding treatment wishes so that your proxy has a guide. You can leave all decisions about treatment to your representative if you decide to do so. But understand that if you are vague about what you want, it can create conflict and indecision within the family when the time comes to make those decisions.
Some of the responsibilities of a health proxy are complicated and stressful. Here are some of the following tasks they may be required to undertake:
- A health care proxy must represent your interests and be able to make informed medical decisions on your behalf as specified in your proxy document.
- A health care proxy consults with the medical team, reviews the medical chart, asks questions regarding treatment decisions, and ensures that those decisions are compatible with your wishes.
- A health care proxy can request second opinions.
- A health care proxy can consent to or refuse medical tests or interventions on your behalf.
- A health care proxy can authorize the transfer to another doctor or healthcare setting.
- In some states, a health care proxy form allows the designated person to obtain medical information and speak with healthcare providers even if they can communicate. But, they can’t make any medical decisions on your behalf.
How Do You Appoint a Health Care Proxy?
Before deciding who to appoint, your first step is to ensure you use the correct state forms for advance directives. If you are unsure how to fill out advance directives and health care proxy forms, you can consult an estate planning attorney.
Next, take these steps to select the right person and follow through with tasks to ensure everyone has what they need. Remember, you can change your health care proxy at any time for any reason. That is your right.
Step 1: Select your health care proxy
This might be the easiest step for you if you are married or have a partner. Most people will choose their spouse for this role. For single, divorced, or widowed people, this may be harder. Consider these ideas and criteria for selecting the best person.
Think carefully about what you want
It can be helpful to talk with your family and health care providers when making medical decisions. In particular, try and get a good understanding of medical interventions and expected outcomes
You must trust the person you select as your health care proxy. This might seem obvious, but if you have doubts, take your time and choose someone else. You might consider a nephew, niece, aunt, uncle, clergy, lawyer, or close friend.
Responsibility works both ways when selecting a health care proxy. You have the responsibility of informing your potential proxy about the level of commitment they will have. They have the ethical duty of following your directives.
Step 2: Fill out and sign
Many health care proxy forms require a notary and witness, and some require a witness only. The form must have the state-required signatures, or it isn’t valid. If you are unclear about the process, seek out the counsel of an attorney.
Step 3: Share your health care proxy form with healthcare providers, family, and trusted people
If providers don’t have your health care proxy form and you are unable to make decisions, they are required to make medical decisions on your behalf. Some of these decisions may end up being contrary to your wishes.
Adding your health care proxy to your Cake profile is easy, where you can share it with trusted people. In addition, make certain that every healthcare entity scans a copy into your medical record. Keep the original in a safe place. And don’t forget that if you change your healthcare proxy, the new one takes precedence over any previous ones.
Step 4: Review yearly or more often as needed
At least once a year, review your health care proxy document and update as needed. If your medical situation changes, you might think about who your health care proxy is and what interventions you want.
When Does a Health Care Proxy Take Effect?
A health care proxy takes effect when a doctor determines that a person cannot make their own healthcare decisions. There are several circumstances when this might occur.
When cognitive impairment becomes so severe, a person is not able to make well-reasoned healthcare decisions. Guardianship may be necessary in those cases to determine incapacity. Guardianship is a legal process that appoints a person to manage your healthcare and financial decisions. Some proxy forms allow you to designate who you want that person to be if you meet the legal standard for incapacity.
A person might become unconscious and unable to communicate due to many causes. A head injury, heart attack, anesthesia, stroke, or other medical event renders the person unable to make medical decisions.
Delirium is a significant disturbance in mental abilities that results in confusion and disorientation. Delirium can be caused by a severe or chronic illness, low sodium, dehydration, medications, infection, surgery, or alcohol or drug intoxication or withdrawal.
A Health Care Proxy and Peace of Mind
Everyone has the right and responsibility to guide their health care in ways consistent with their values and belief system. Over the years, you may have given great thought to what you are comfortable with when it comes to your healthcare. Now is the time to do the challenging work of appointing a health care proxy and specifying your wishes. Doing so can give you and your family peace of mind.