Thus, the power of attorney for health care can cover as broad a range of health care decisions as the principal desires. Once in effect, the agent can act in the here-and-now, review the medical record, serve as an advocate, discuss care and questions with the medical staff, and decide what the principal would want or what is in the best interest of the principal if the principal's wishes are not known.
The health care power of attorney can include a living will provision—a description of health care preferences—or any other instructions but should, preferably, do so only as guidance for the agent, rather than as a binding instruction. The agent should be selected with great care. A person who strongly wishes to avoid aggressive medical treatment should not name an agent who might not carry out such wishes.
For example, selecting as agent a person who believes that every possible medical intervention should be used to prolong life, or a spouse whose emotional state might make it difficult to limit or terminate care, may not be wise. A better choice might be a trusted associate, advisor, or a longtime friend. Principals should discuss the goals, values, and wishes they want agents to use as guidance, because agents will need all the guidance possible when making decisions that can be extremely difficult.
In addition, a principal should make sure that the agent is willing to take on this responsibility before the principal names the person as agent. In most states, two or more people may be named to serve as agents together jointly or alone severally.
However, such joint appointments can create conflicts and complications and should probably be avoided or discussed with an attorney. If feasible, the health care power of attorney should name an alternate or successor agent in case the first-named person is unable or unwilling to serve. The law of each state describes the rules and procedures necessary for making a valid health care power of attorney as well as living will. These rules should be followed carefully. Most states require two qualified witnesses to sign the document, and some permit notarization as an alternative.
A principal who has capacity can cancel the health care power of attorney at any time. The choice of agent does not have to be permanent.
The health care power of attorney is important for younger as well as older adults because a health care agent can act during periods of temporary clinical incapacity as well as during more likely permanent incapacity near the end of life. It is especially important for anyone who wants someone other than next of kin to control decision making for example, a partner, friend, or anyone else legally unrelated.
It is the only way, outside of a court proceeding which is a complicated process , to give that person the legal authority to make health care decisions and to ensure rights of visitation and access to medical information.
Ideally, copies of the living will or health care power of attorney should be given to every doctor providing care for the principal and to the hospital upon admission. People should also provide copies to other close family or friends who will likely be involved during serious illness. This helps avoid surprise and controversy when difficult decisions have to be made by the agent. Web-based databases that store information about peoples' advanced directives and that can be accessed by health care practitioners are becoming increasingly available.
Advance directive smartphone apps are also available, allowing people to store advance directives, share them with family members, and send them electronically to doctors. Having multiple advance directives or ones that are overly complicated can create confusion. If there is both a living will and a health care power of attorney, the principal should stipulate which should be followed if the documents seem to conflict. In general, a health care power of attorney is preferable if the principal has a trusted person to appoint as agent.
A health care power of attorney is particularly important for all adults, even younger adults, who want someone other than next of kin to control decision making for example, a partner, friend, or anyone else legally unrelated.
Advance Care Plan Registry. Doctors can easily access digitized copies of patient documents from the Registry to make informed decisions about patient end-of-life care. It is a good idea to carry a copy of your advance directive when traveling. You may also create a wallet-sized card that indicates you have an advance directive, identifies your healthcare agent, and contains instructions for where to find your directive. The U. Advance Care Plan Registry produces a card for you when you register.
It contains your instructions for medical treatments for specific health-related emergencies or conditions. The instructions are based on decisions made by you and your healthcare team. The two are complementary. You can review or change your advance directive at any time. The Disparity of Hope. Share This Share on facebook Share on twitter Share via email.
Purpose of an advance directive also known as a living will or healthcare power of attorney : To articulate and document your wishes concerning medical treatment should you lose decision-making ability.
To designate an individual, known as your healthcare agent or proxy, to ensure your wishes are honored should you no longer be able to speak for yourself. This includes, among other things, making decisions about when to withhold or withdraw life-sustaining treatment.
Where to find an advance directive form: The National Hospice and Palliative Care Organization has a list of advance directive forms for every state. What to include in your advance directive: The name and contact information of your healthcare agent or proxy. Answers to specific questions about your preferences for care if you become unable to speak for yourself.
The forms and questions asked vary a bit from state to state. All situations? Would you want treatment only if a cure is possible? You should address a number of possible end-of-life care decisions in your living will.
Talk to your doctor if you have questions about any of the following medical decisions:. You don't need to have an advance directive or living will to have do not resuscitate DNR and do not intubate DNI orders.
He or she will write the orders and put them in your medical record. Even if you already have a living will that includes your preferences regarding resuscitation and intubation, it is still a good idea to establish DNR or DNI orders each time you are admitted to a new hospital or health care facility.
Advance directives need to be in writing. Each state has different forms and requirements for creating legal documents. Depending on where you live, a form may need to be signed by a witness or notarized. You can ask a lawyer to help you with the process, but it is generally not necessary.
Review your advance directives with your doctor and your health care agent to be sure you have filled out forms correctly. When you have completed your documents, you need to do the following:.
You can change your directives at any time. If you want to make changes, you must create a new form, distribute new copies and destroy all old copies. Specific requirements for changing directives may vary by state. You should discuss changes with your primary care doctor and make sure a new directive replaces an old directive in your medical file. New directives must also be added to medical charts in a hospital or nursing home. Also, talk to your health care agent, family and friends about changes you have made.
In some states, advance health care planning includes a document called physician orders for life-sustaining treatment POLST. This form does not replace your other directives. Instead, it serves as doctor-ordered instructions — not unlike a prescription — to ensure that, in case of an emergency, you receive the treatment you prefer.
Your doctor will fill out the form based on the contents of your advance directives, the discussions you have with your doctor about the likely course of your illness and your treatment preferences.
If you are in a hospital or nursing home, the document is posted near your bed. If you are living at home or in a hospice care facility, the document is prominently displayed where emergency personnel or other medical team members can easily find it. Forms vary by state, but essentially a POLST enables your doctor to include details about what treatments not to use, under what conditions certain treatments can be used, how long treatments may be used and when treatments should be withdrawn.
A POLST also indicates what advance directives you have created and who serves as your health care agent. There is a problem with information submitted for this request. Sign up for free, and stay up-to-date on research advancements, health tips and current health topics, like COVID, plus expert advice on managing your health. Error Email field is required.
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