Everyone age 18 and over should have a health care proxy document signed (think kids off to college, and yourself, not just an elderly parent). A health care proxy, also called a medical power of attorney, is a legal document in which you designate someone to make medical decisions if you can’t do so for yourself. Here’s the five biggest mistakes people make on this vital document.
Not Completing and Signing a Health Care Proxy Document
No 1: Not having one. One study found that 67% of adults don’t have a health care proxy. If you don’t have one medical professionals may have to make decisions in a vacuum. Your wishes may not be respected. Or worse a court might have to get involved to resolve decisions. That might require appointment of a guardian to make decisions in some cases. A key reason many people do not sign health care documents is they found the process uncomfortable. But consider the ramifications of your wishes being ignored or loved ones with different views on health care decisions for you fighting over what should be done. Don’t put this one off. You might be able to get a simple form from your medical provider or online, or buy an inexpensive document from an online legal service, or better still, hire an estate planner in your state to create a custom document for you. But however you address it, get it done.
Not Having “The Talk” With Your Agent
No. 2: Not speaking to the people you appoint to make decisions (your health care agent). Signing a legal document is a great first step, but if you don’t have a discussion with the person you name as your agent, how will they know your wishes? The conversation doesn’t have to be complicated or long, and it doesn’t have to occur in one discussion. But it is really important to give your agent some understanding of your feelings and wishes. If you have a known health issue, or a family history of one or more health issues, express your feelings to your agent. Discuss hypothetical medical issues and how you would feel about them so that the agent gets an understanding of your wishes. These are not easy discussions, but lots of important things require tackling tough issues. If you had a terminal illness and you were expected to live less than six months what type of care, surgery, intervention, etc. would you want or not want? If you develop a progressive dementia what type of care, surgery, intervention, etc. would you want or not want? If you develop a degenerative chronic disease, what type of care, surgery, intervention, etc. would you want or not want? If as you age you become frail and cannot live independently, would you want to stay in your home with help or be moved to a long term care facility with more socialization?
Religious Considerations
No. 3: Not addressing religion. Many people were born into a particular faith, or to a family that adhered to a particular faith. How do you feel about the customs and standards of that faith applying to your medical decision making? If your faith has evolved and is now stronger or less than what your family observed, how might that affect your agent’s decisions for you? If you have changed faith or married someone of a different faith, or have children with differing religious views, addressing this both in your health care documents and your discussions with your agent is vital. These are simple but vital points to address. Don’t dismiss religious considerations because you are not religious. That too is essential to explain and document. Also, don’t assume that because your family is of a particular faith, or that you attend services on a regular basis that your agent will know. Best to document and discuss. Some of the most emotionally charged and acrimonious end of life decisions are over different understandings of what an ill family member wanted done.
Have a “Go Envelope”
No. 4: Not having readily available copies. Put together an envelope and write your name, address, phone number and those of your agents on it. Put inside the envelope a copy of your health insurance and drug cards and your health care proxy. If you also created and signed a living will (a written statement of your health care wishes that gives guidance to your agent) and/or a POLST (Physical Order for Life Sustaining Treatment) that you signed with your doctor, add copies of those to the envelope. You might also have signed (and if not consider this too) a HIPAA release. This is an authorization to access your medical records and communicate with your medical providers. Put the envelope someplace easy to find and let everyone close to you that you might rely on know its location. Too often emergencies happen at the least opportune, least expected and most difficult of times (think 2 am on a holiday weekend). Best to have this vital information, including the contact information for your health care agent and an extra copy of the document, at the ready. If your physician will hold copies of these documents in your medical records, that is a great preparatory step to take. Be sure to give the above information to your agent as well.
Addressing Financial Aspects of Health Care
No. 5: You need to also address financial matters. Your health care agent probably won’t have any legal rights to pay medical bills, costs for a care giver, etc. Certainly whatever insurance coverage you have is key and as mentioned above that information should be in your “Go Envelope.” But you should also sign a durable power of attorney which is a financial document designating a person (also called an agent) to handle financial matters for you. Be sure to tell that financial agent the information they need to help (e.g. bank account info) but also that they should follow, respect and pay for the costs of health care decisions made by your health care agent. If you have an attorney prepare customized estate planning documents for you, discuss with your lawyer adding a directive to the financial power of attorney document requiring the financial agent to fund medical and health care decisions made by your health care agent.