Over 18 and Not Married? You Need a Health Care Proxy!
What is a Health Care Proxy? Below is the definition from Google:
“A health care proxy (also known as a durable power of attorney for health care, medical power of attorney or appointment of a healthcare agent) is a document that lets you to appoint another person (a proxy or agent) to express your wishes and make health care decisions for you if you cannot speak for yourself.”
It’s not something we like to think about, but it is in your best interest to appoint someone you know and trust to become your Health Care Proxy in the event you become incapacitated and cannot speak for yourself. This person will advocate on your behalf to receive the medical care and treatments that you want. If you are married, your spouse is your health care proxy. If you are under the age of 18 years old, your parents (or guardian) have the power to make health care decisions for you.
Now why am I writing a blog about Health Care Proxy? Well, what happened in my office three years ago and again recently, motivated me to write this blog. I thought it was important to share, since I wasn’t aware of this, and I wondered how many of you are not aware about appointing a Health Care Proxy.
One of my patient’s sons who had just turned 18 years old was rushed to the local hospital for emergency treatment. He was NOT able to speak on his own behalf. He lives with his mother, who was present in the hospital. She asked the doctor about her son’s condition, and was told that since her son was 18 years old, he could not discuss her son’s condition with her unless she was his Health Care Proxy. Her reaction was, “I’m his Mother! I want to know my son’s condition and what are you doing to him.” The doctor calmly explained that her son was now an adult and even though she was his mother, unless she was his health care proxy, he was not allowed to discuss her son’s condition or treatment. At this point, my patient loss it and started crying uncontrollably. He had just turned 18 years old earlier that week. She pleaded with the doctor, who refused to give any information.
The good news, her son became conscious later that day and signed a note allowing his mother to be privy to his medical information.
Days later, my patient was still visibly upset about this encounter. She now has a proper Health Care Proxy for all her adult children who are over 18 years of age. Knowing this information, I quickly did the same for all my children, yet had not thought about my own situation. I was married for 35 years and my husband, who is a medical doctor, was my health care proxy and I was his. With the advent of the divorce, my ex-husband is no longer my Health Care Proxy.
Suddenly, I had to decide who I would choose to make medical decisions on my behalf. I realized that with my medical condition, it had to be someone who understood my condition, my philosophy about life and healthcare, along with knowing my long list of allergies to medications and foods. I believed I chose wisely. However, recently, that person who I appointed as my Health Care Proxy died. This made me realize I had to choose someone younger than me who met the above criteria. After long discussions, I found someone who agreed to do it.
Being aware of the need of a Health Care Proxy, I often ask my patients over 18 years old if they have one. The reason I really got motivated to write this blog was this past week two of my patients, who are over 18 years old, had never heard of a Health Care Proxy. One of them is a 27 year old woman who had a concussion and worked in the health care system. She lives on her own. When asked, she just assumed that her mother, who she highly respected, would be there to speak on her behalf. “Wrong,” I told her.
I relayed the story about my other patient, and told her she needed to complete a Health Care Proxy form and officially appoint her mother. Then I asked her who her mother’s Health Care Proxy was. She asked her mother, and guess what? She does NOT have a Health Care Proxy, but knowing this information she will now appoint one.
The other person is also a patient who had a concussion and lives at home with his mother. He recently turned 18 years old. I asked him if he knew that he needed a Health Care Proxy to make medical decisions for him if he was knocked unconscious and was unable to speak on his own behalf. He said, “What do you mean? If I can’t speak for myself?” I said, “Yes.” His answer was his mother. When I explained to him that this was not the case, he quickly asked how to obtain a Health Care Proxy. I told him he can go to any hospital and obtain the medical forms. He wondered why his PCP never discussed having a Health Care Proxy. I said they ought to do this. Then I realized I just had my yearly physical with my PCP. She asked me many questions like if I smoked and what medications do I take. She even advised me about immunizations. However, she never asked if I had a Heath Care Proxy and who was that person in case I was unable to speak on my own behalf.
This is a very, very serious situation, because if you are over 18 years of age and are not married, and if you cannot speak on your own behalf, then a doctor, medical center, hospital, EMT, and even assisted living staff can make decisions regarding treatments, methods and type of medical care to provide for you.
Some of you may be fine with that, however, if want the ability to choose how, when, where and what type of medical care you want, then I urge you to appoint a trusted person to be your advocate. If you are at least 18 years of age, and unmarried, you need to immediately get the necessary form and decide who you really want to trust the quality of your life.
Choose Your Health Care Proxy Wisely
When choosing someone to be your “voice” there are many factors to consider. Make sure your emotional connection to this person will not impact their ability to make decisions on your behalf, even if they don’t agree with your wishes. Be sure this person is confident and comfortable to be able to speak to doctors, and other medical staff and will ask for clarification if they do not understand what is happening. They could be making decisions about life-saving procedures such as CPR, life-sustaining treatments such as tube feedings and respirators, as well as other procedures such as consent for treatments, surgery, blood transfusions, pain medications and other tests. The person you choose as your Health Care Proxy should be someone who knows what decisions you would make for yourself if you were able to do so. You are granting them a major responsibility.
A Health Care Proxy has the right to make the decisions on the following:
- Medical care, including medical tests, medication, or surgery
- Requesting or declining life-support treatments
- Pain management, including authorizing or refusing certain medication or procedures
- Where you will receive medical treatment, including authorization to move you to another facility, hospital, or to a nursing home or hospice facility
- Taking legal action in order to advocate for your health care rights and wishes
- Applying for insurance benefits or programs on your behalf
Your Health Care Proxy is primarily responsible for managing your medical care. This may include
- Learning about your medical condition and treatment options
- Communicating with your medical team
- Understanding and asking questions about your condition, and available treatment options
- Reviewing your medical history/chart
- Communicating with your family members about your condition and treatment plan
- Accessing and approving release of your medical records
- Requesting second opinions or alternative medical care/treatment options
It is important for you and your Health Care Proxy to discuss your wishes in advance, so they know how to best advocate for you. I highly recommend discussing your wishes now, while you are able to communicate, preparing your Health Care Proxy to represent you in the event something should happen.
Suggested Topics to Discuss
Here are some suggestions to discuss with your Health Care Proxy:
- Allergies, food/medicine, other
- Chronic Conditions, any ongoing medical conditions
- Previous surgeries, when/why
- Current Medications, why
- Medical treatments that you would prefer not to receive, why
- End of life wishes
- Are there any life-support treatments that you would or would not like to receive?
- What are your feelings regarding mechanical breathing (respirator), cardiopulmonary resuscitation (CPR), artificial nutrition and hydration, hospital intensive care, pain management, chemo or radiation therapy, and surgery?
- Would you want Antibiotics, if you developed a life-threatening infection?
- Would you prefer to remain at home if possible, or be in a hospital or hospice environment?
- Any religious or spiritual wishes?
There are many resources available to help you and your Health Care Proxy develop a care plan. These are merely suggestions to get you thinking about possible scenarios and topics to discuss.
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