What is a healthcare proxy?
A healthcare proxy is a document that gives someone the power to make healthcare decisions for a person who cannot do so. People may also refer to it as a durable power of attorney for healthcare.
On a proxy, a person names someone they trust to act on their behalf in the event of a serious injury or illness. It may work together with a living will, but it can also stand on its own.
Most states give people the flexibility to decide which medical decisions they want to delegate to their representative on the proxy.
Below, we describe legal considerations, tips on choosing a representative, and more.
The definition
This article originally appeared on Medical News Today
As the National Institute on Aging (NIA) explains, a healthcare proxy is a legal document people use for advance care planning. Another name for this document is a “durable power of attorney for healthcare.”
Its purpose is to nominate someone to make a person’s healthcare decisions in the event of an illness or injury. Other names for the nominee include proxy, agent, surrogate, or representative.
A healthcare proxy is one type of advance directive, and a living will is another. Advance directives allow people to express their wishes in the event that they cannot communicate them.
How a healthcare proxy works
A healthcare proxy takes effect when a doctor determines that the person cannot make their own healthcare decisions.
At that point, the person’s healthcare representative steps in. They make medical decisions according to the preferences that the proxy expresses. This might involve choosing from a range of treatment options and identifying where a person will receive care. However, the responsibilities of a healthcare proxy can vary by state.
When the person can once again make these decisions, the representative stops acting on their behalf.
A person can change an advance directive, including a proxy, at any time.
Expressing preferences
Ideally, a person with a healthcare proxy explains their treatment preferences to their representative in advance. The discussion might also include preferred steps to extend life and efforts to prioritize the quality of life.
In addition, the person with the proxy might do some research and describe their preferences regarding the need for:
A living will
An individual might put their healthcare preferences in writing by creating a living will.
According to the American Bar Association, a living will applies in situations in which the decision to use life-sustaining treatments may prolong an individual’s life for a limited period, and not obtaining such treatment would result in their death.
By contrast, most states allow someone nominated on a proxy to step in when the person becomes incapacitated, not just in end-of-life situations. For example, if a person is unconscious or their mental state means that they do not have the legal capacity to make their own decisions.
A person might have a healthcare proxy instead of, or in addition to, a living will. A proxy may be the right choice for someone who does not want to put specific healthcare preferences into writing.
Who can be named?
Generally, a person can appoint anyone ages 18 or older as a healthcare representative. However, in Nebraska and Alabama, a healthcare proxy must be 19 or older. They may be a:
spouse
partner
family member
friend
lawyer
neighbor
Although laws vary by state, the healthcare representative is typically not the person’s doctor or another medical staff member.
Many states also allow a person to name an alternate representative to serve as a backup if the first cannot carry out their responsibilities.
Additionally, states usually allow people to decide how much authority to give their representatives and what decisions they can and cannot make.
What are the legalities?
Many states have their own healthcare proxy forms. While a lawyer is unnecessary for creating advance directive documents, a person might ask one for help.
States often require one or more witnesses to sign the proxy. Typically, a witness should not be a family member, the representative named on the proxy, a healthcare professional, or anyone named in the person’s will.
Some states recognize advance directives from other states. That said, the National Hospice and Palliative Care Organization (NHPCO) recommends that anyone who spends a lot of time in more than one state prepare advance directives in each.
Handling finances
A healthcare proxy allows a representative to make healthcare decisions, but a different document empowers someone else to handle a person’s finances.
A financial power of attorney document deals with financial decisions. It allows the named individual to handle financial matters for someone who is incapacitated.
A person might decide to give this financial representative the power to manage medical payments or change health insurance plans.
It is possible to nominate the same person to make financial and healthcare decisions, but states generally require two separate documents.
Advance care planning
Medicare Part B covers advance care planning as part of a person’s annual wellness visit.
There is no cost for the planning when it is part of the wellness visit.
Medicare resources
For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.
Access to medical records
A healthcare representative and the named person on the healthcare proxy usually have access to the medical records of the person they are representing.
A person can also send Medicare a CMS 10106 authorization form allowing others to view their health information. This authorization remains in place until the person states in writing that they would like to reverse it.
Advice and resources
Before nominating a representative, it is a good idea to discuss the responsibilities with them to ensure they are comfortable taking on the role.
According to the NHPCO, a good representative is someone:
who really understands the person being represented and how they would make the decision if they were able
who is able to stay calm in stressful situations
who is unafraid to question doctors and will advocate for the person’s preferences
who is good at communicating with others, including family members
Anyone who would like assistance with a proxy or another advance directive can contact:
their state attorney general’s office
their state department of health
the NHPCO
the AARP
their state bar association
their local Veteran’s Affairs (VA) office, if they are a veteran
Summary
A person uses a healthcare proxy to ensure that their medical preferences are carried out if they are ever unable to communicate due to illness or injury.
Creating this document can be an important step for adults of any age.
Considering the options and nominating a capable representative can ease pressure on friends and family members in a medical emergency.
View the original article on Medical News Today
