Picking a Healthcare Power of Attorney to Protect End of Life Wishes

Have your senior loved ones made advance directives decisions, including “Do Not Resuscitate” or DNR orders,  and made them known yet?

Do you have a copy of their advance directives? Do you know where a copy is?

Have you made your own advance directives yet? What happens to your senior if you are unable to continue to provide care for them?

We should be making sure our seniors (ourselves too) have made their wishes known and have designated the person who will carry out those wishes – or ensure they’re carried out – at the end of life.

We have some tips for selecting the person who will act on your senior’s behalf (or your own) when the time comes.

A Healthcare Power of Attorney (POA) is the person empowered by an individual to make decisions regarding healthcare and medical treatment when that person is unable to make decisions or consciously communicate intentions regarding treatments. This designated person is often also called an agent.

Selecting a Healthcare Power of Attorney

1. The person selected as POA or agent should be an adult of sound mind.
2. Select only one person so that there will be no disagreements over what to do, as more than one may not be able to carry out the wishes set forth. Avoid the pitfall of picking all the children who may disagree with the wishes and be unable to carry them out.
3. Choose someone in whom there is confidence that appropriate action will be taken, someone who will make the same decisions as would the person for whom they are acting. This person should be able to support the wishes and act fully to be sure desires are accurately and fully met.
4. Select a person who is reasonably expected to be available when the time comes to make decisions, lives nearby, is able to talk with healthcare team members and be willing to devote his or her attention to the necessary healthcare decisions.
5. Pick someone who can be trusted, but preferably not an employee or staff member at a facility in which the person lives, nor any healthcare providers. The person selected should not be serving as power of attorney for too many other people. A limit of ten is seen by some as the maximum manageable.
6. The person selected needs to fully understand and agree to fulfill the POA role.
7. The agent should be fully aware of all appropriate decisions and wishes. They should be able to stand up to others who disagree with those wishes, including family, friends or the healthcare team. They should be able to handle conflicts that may arise.

Your senior loved one will need to complete a legal form to document who they select as a power of attorney. You may want to suggest they consult an elder law attorney (maybe you can join them) so that they can be sure of using the correct form, as the requirements vary from state to state.

It might also make sense to select a backup POA who also meets the above criteria, stating that if the primary agent is unable to make and enforce the necessary decisions then the backup person is empowered to take action. This is helpful in the event that the first choice becomes incapacitated or otherwise unable, or even unavailable, to carry out the wishes of your senior loved one.

Document All Decisions & Wishes

Now will be the time to have your senior loved one’s wishes documented so there is no question at the end of life and their designed agent will be fully aware of, and able to demonstrate, those wishes. Once this document is completed, copies should be provided to the agent and family members.

These are some decisions that should be considered and included in the documentation if the answers are important.

• Is it desired that everything be done to extend life or is the preference to die peacefully?
• Is there a preference for a full funeral or a small service; burial or cremation?
• Is it important to die at home surrounded by family and friends or be left alone in peace?
• If burial is desired, are specific clothes important?
• There are many details large and small that may be important and thus need to be expressed on paper so that desires can be met and enforced.

Naturally, once a power of attorney has been selected, there should be a complete discussion about wishes, instructions regarding where the documents can be found and a handover of a copy in case of emergency. If there are family members who may not agree with decision, it is best to face that head on and tell everyone what has been decided. They shouldn’t be left fighting over who gets to be in charge when they should be focusing on the time spent with a loved one near the end. Open communication with family members now when your senior loved one has their wits about them instead of waiting until those wishes come into question.

Advance directives and healthcare powers of attorney are legal documents that can be changed in the future if wishes or the situation changes as long as your senior loved one is competent to make decisions.