Also known as a health care proxie, health care representative, durable medical power of attorney or a patient advocate, a durable power of attorney for healthcare is a very important document for anyone, but especially for someone with Alzheimer's and other types of dementia.
A healthcare power of attorney is someone you choose to make health and medical decisions for you if you're unable to make them for yourself. As dementia progresses, knowing you have someone in place to make healthcare decisions when you are no longer to do so can bring a peace of mind.
Who Can Designate a Healthcare Power of Attorney?
You must be "of sound mind" and over the age of 18 to complete paperwork for a healthcare power of attorney. The definition for the term "of sound mind" is not clearly outlined. However, many clinicians argue that a person who might be unable to make appropriate medical decisions can still designate someone to serve as their healthcare power of attorney. This is because you might be able to clearly understand and communicate a choice of who you want to make medical decisions for you, but display impaired judgment or be unable to adequately understand more complex medical decisions.
How to Designate a Healthcare Power of Attorney
- Choose Someone to Designate
Consider your family and friends in light of this role. For some people, there's an easy, obvious choice. If that choice is not so clear, be certain to choose someone who knows you well and who you're confident will make decisions with your best interest in mind.
- Choose an Alternate Person to Designate
You are not required to choose an alternate person, but it's usually a wise choice. Designating an alternate is helpful because if something unexpected happens to the first person you designate, the alternate can then serve as your medical power of attorney, rather than you having to set up a whole new medical power of attorney document.
- Ask the Person if She's Willing to Serve
Speak with the person(s) you've chosen and ask if they are willing to serve in this role. If it's a family member, the answer might be a given if they were already assuming that they'd make the healthcare decisions when the time comes. They may even have been the one to suggest you complete this paperwork. There are some people, however, for whom medical decisions and settings are intimidating or anxiety-provoking, so it's a good idea to confirm their willingness to be your medical power of attorney if this topic has not been previously discussed together.
- Communicate Your Medical Preferences Clearly so They Don't Have to Guess
One thing you can do to make the healthcare power of attorney role easier is to clearly communicate ahead of time your thoughts and wishes regarding medical decisions. You may want to indicate your wishes in writing through a living will. While not all states legally recognize a living will, it still provides your loved one with clear knowledge of your preferences and medical choices.
- Acceptance of the Patient Advocate Responsibility
The person you designated as your power of attorney for healthcare needs to sign on the form indicating that they accept this responsibility.
- If Necessary in Your State, Notarize the Document
Some states require the document to be notarized. If so, you'll need to locate a notary public and sign the form in their presence. Financial institutions, such as banks, insurance agencies or government offices often have notary services available. Call ahead to verify where notary services are offered.
- Distribute Copies
Give copies to your physician, other family members, and your attorney. Generally, copies should be accepted as an original, and often language is in the power of attorney document to convey that a copy is as good as an original document. Occasionally, banks or other financial institutions might require the original document to be brought in, regardless of the language included in the document requesting acceptance of a copy.
Do I Need an Attorney to Draw Up a Power of Attorney Document?
Most state websites have free forms that you can use without an attorney to designate a patient advocate / durable power of attorney for healthcare. For some states, these forms are combined with a living will, where you can also specify your wishes for medical care.
You may should consult legal advice from an attorney if you have further questions or extenuating circumstances. Some people are simply more comfortable if an attorney draws up the document. Others may have had their attorney write up their will and a power of attorney form for healthcare might have been included in the package.
Do I Need Witnesses?
The majority of forms require two witnesses. Some have an option for a third witness. Other forms require two witnesses or a notary public to notarize the document. The witnesses usually sign a statement indicating that the person executing the document appears to be of sound mind and, to their knowledge, is not under duress or undue influence.
Who Can Serve as Witnesses?
Some forms identify specific individuals who may not be your witnesses. For example, the Ohio form states that a witness may not be "the agent or any successor agent named in your Health Care Power of Attorney; your spouse; your children; anyone else related to you by blood, marriage or adoption; your attending physician; or, if you are in a nursing home, the administrator of the nursing home."
What Kind of Decisions Might a Healthcare Power of Attorney Need to Make?
Medical decisions can vary widely and include whether to send a person to the hospital, permission for certain medications or surgical procedures, home care or nursing home placement, nutrition and hydration choices, resuscitation directions and much more.
It's unlikely that you can anticipate every possible medical decision that may need to be made, so that's why it's so important to communicate your specific choices as well as your general preferences regarding medical care to your designated power of attorney for healthcare. Completing a living will and designating a durable medical power of attorney enable you to increase the amount of control you have over your future medical care. They also help your loved ones know how best to honor your wishes and choices.
**Please note that many states differ in their specific requirements for a healthcare power of attorney. Therefore, it is imperative that you consult your state's legal requirements prior to completing paperwork for a healthcare power of attorney designation and activation. The information included on this website and linked to both on and from this site is opinion and information. While I have made every effort to include accurate and complete information, I cannot guarantee it is correct. Please seek legal assistance, or assistance from State, Federal, or International governmental resources to make certain your legal interpretation and decisions are correct. This information is not legal advice and is for guidance only.**The information in this article is not to be misconstrued as legal advice.**
California. Advance Healthcare Directives Form. Accessed August 30, 2012. ag.ca.gov/consumers/pdf/ProbateCodeAdvancedHealthCare
Cleveland Clinic. Advance Directives. Accessed August 30, 2012. http://my.clevelandclinic.org/patients-visitors/legal-ethical-decisions/personal-medical-decisions/advance-directives.aspx
Conneticut.gov. Your Rights To Make Health Care Decision; A Summary of Connecticut Law. Accessed August 29, 2012. www.ct.gov/ag/lib/ag/health/yourrightstomakehealthcare
Illinois Guardianship and Advocacy Commission. Guardianship Frequently Asked Questions. Accessed August 30, 2012. Guardianship Frequently Asked Questions
Massachusetts Medical Society. Important Differences Between Health Care Proxies and Living Wills. Accessed August 30, 2012. http://www.massmed.org/AM/Template.cfm?Section=Home6&TEMPLATE=/CM/HTMLDisplay.cfm&CONTENTID=10979
Michigan State University Extension. Does a durable power of attorney need to be notarized or witnessed? Accessed August 29, 2012. http://www.extension.org/pages/43868/does-a-durable-power-of-attorney-need-to-be-notarized-or-witnessed
Michigan.gov. Patient Advocate Designation. Accessed August 29, 2012. www.msu.edu/~betz/estateplanning/2004%20EstatePl
New York State. Department of Health. Medical Orders for Life Sustaining Treatment (MOLST). Accessed August 30, 2012. http://www.health.ny.gov/nysdoh/ems/policy/08-07.htm Texas Medical Association. Medical Power of Attorney. Accessed August 29, 2012. http://www.texmed.org/Template.aspx?id=65
Virginia State Bar.An Agency of the Supreme Court of Virginia. Healthcare Decisions Day. Virginia Advance Directives. Accessed August 30, 2012. http://www.vsb.org/site/public/healthcare-decisions-day/