A serious illness or unexpected injury can make it difficult or impossible to communicate with your medical team. If that happens, someone may need to make healthcare decisions on your behalf.
A healthcare power of attorney allows you to choose who that person will be.
This document is an important part of advance care planning. It gives someone you trust the authority to make certain healthcare decisions if you cannot make or communicate those decisions yourself. The person you choose may be called your healthcare agent, representative, surrogate, or another term depending on where you live.
Understanding how a healthcare power of attorney works can help you decide who you would trust with that responsibility. It can also help you prepare that person for decisions they may someday need to make.
What Does a Healthcare Power of Attorney Do?
The American Cancer Society explains that a durable power of attorney for healthcare, also known as a medical power of attorney, allows you to name someone you trust to make decisions about your care if you cannot make those decisions yourself.
The name and requirements for this type of document can vary by state. Regardless of the terminology, it serves a different purpose from a living will. A living will records your preferences about certain medical care and treatment. A healthcare power of attorney identifies the person who can make decisions on your behalf.
This can be particularly valuable because medical situations do not always unfold exactly as expected. Written instructions can address important choices, but they cannot anticipate every possible illness, injury, treatment, or complication.
Your chosen decision-maker can consider the circumstances as they happen. They can also communicate with your healthcare team and help apply your wishes to situations that may not be specifically addressed in your written instructions.
When Does Your Healthcare Agent Make Decisions?
Naming someone in a healthcare power of attorney does not mean you give up control of your own medical care.
As long as you can make your own healthcare decisions, you continue to do so.
The authority granted through the document is intended for circumstances in which you cannot make or communicate those decisions yourself. The exact requirements for determining when an agent may act vary by state.
Incapacity can arise in different ways. A person might be unconscious after an accident, unable to communicate after a stroke, or too ill to understand and make a particular medical decision.
This is one reason healthcare powers of attorney are not only relevant to older adults or people facing a serious diagnosis. An unexpected medical emergency can happen at any age.
What Decisions Might a Healthcare Agent Need to Make?
The authority of a healthcare agent depends on state law and the terms of the healthcare power of attorney.
The decisions involved can be significant. An agent may need to communicate with physicians, consider treatment options, review medical information, or make choices about where care will be provided.
Depending on the authority provided by the document and applicable state law, an agent may also face decisions involving medical procedures, medications, life-sustaining treatment, or other aspects of care.
The role is not simply about choosing between two treatments. An agent may need to ask questions, gather information, and consider how the available options fit the patient’s wishes and priorities.
A healthcare power of attorney is also different from a financial power of attorney. Authority to make healthcare decisions does not automatically give someone control over your money or financial affairs.
These documents address different responsibilities, even if you choose the same person to serve in both roles.
Choosing Someone You Trust
Choosing an agent involves more than deciding who knows you best.
The person should be willing to carry out your wishes, even when those wishes are different from what they would choose for themselves. They may also need to ask difficult questions or advocate for your preferences during a stressful situation.
Consider whether the person can remain calm when decisions become emotional. Would they be comfortable talking with physicians? Could they communicate clearly with other family members? Would they be willing to speak up if others disagreed with your wishes?
Availability matters too. A trusted person may be an excellent choice personally but unable or unwilling to take on the responsibility.
It is a good idea to talk with someone before naming them. Make sure the person understands what the role could involve and is willing to serve.
State law may also limit who can act in this role. Requirements can differ, so the appropriate healthcare power of attorney document should comply with the law where you live.
Your Agent Needs More Than a Name on a Document
Completing a healthcare power of attorney is important. Talking with the person you name can be just as important.
Your agent may someday face a situation that your documents do not specifically address. Knowing your priorities can help that person make a decision that reflects what matters to you.
You do not have to predict every possible medical scenario to have a useful conversation.
You might discuss what quality of life means to you, how you feel about certain medical interventions, and what circumstances would influence your treatment choices. You can also talk about the people you would want involved in discussions about your care.
These conversations can give your agent context that a legal document alone may not provide. They can also give your agent an opportunity to ask questions while you are able to answer them.
Those conversations should not necessarily happen only once. Your health, relationships, and preferences may change. Keeping your agent informed can help that person understand your current wishes rather than relying on a conversation from years ago.
Why a Backup Can Matter
Even a carefully chosen agent may not always be available.
The person you initially selected could become ill, move away, die, or simply be unreachable when an emergency occurs. Your relationship with that person could also change over time.
Depending on state requirements and the document you use, you may be able to name an alternate who can step in if your first choice cannot serve.
It is worth giving the same care to choosing a backup as you give to choosing your first agent. The alternate may ultimately be the person asked to make decisions for you.
Both people should understand your priorities and know that you have named them.
Keeping Your Health Care Power of Attorney Within Reach
Preparing a healthcare power of attorney is only part of the planning process. The document also needs to be available when it matters.
Think about who should have a copy of your healthcare power of attorney and how the current version can be located.
This becomes particularly important during an unexpected emergency. You may not be at home when something happens. Your usual doctor may not be treating you, and the person you named may not be physically present when medical decisions arise.
Keeping your healthcare documents accessible can help the appropriate people locate important information when time matters.
If you update the document, make sure the people who may rely on it know about the change. An outdated copy can create confusion at exactly the time clarity is needed.
Planning for the Decisions You Cannot Make Yourself
A healthcare power of attorney gives you a way to choose who can make healthcare decisions for you if you cannot make them yourself.
The document is only one part of that preparation. Choosing the right person, discussing your wishes, and reviewing your choices over time can all help your agent understand the role.
It is also important to make sure the document can be found when it is needed. Your agent and other appropriate people should know that it exists and how to access the current version.
Requirements for healthcare powers of attorney vary by state. If you have questions about preparing or updating your document, consider speaking with an estate planning attorney who is familiar with the laws in your state.
American Cancer Society, “Types of Advance Directives”. Read the full article here.