Suppose You’re Deathly Sick and Can’t Speak for Yourself
Name a healthcare proxy now and save everyone a lot of grief
Fewer than one in four adult Americans has a healthcare proxy, according to a survey by the Transamerica Center for Retirement Research. That means more than 75% of Americans, should they become too sick to communicate their wishes, are leaving loved ones and doctors in the lurch.
A healthcare proxy is a document that tells doctors whom you have appointed as your agent to step in and confer with your doctor when you are unable to speak for yourself, or to process information. This vital document is sometimes also referred to as a medical power of attorney or a durable power omf attorney for healthcare. Sometimes it is embedded as a companion piece of an advance directive (more on this below).
The coronavirus is only the most recent reminder of the importance of having a healthcare proxy, as acute breathlessness from the virus can make it impossible to speak, and, once intubated, communication is not possible. There are, of course, myriad other situations where you may need a proxy ready to step in as your advocate. Stroke. Heart attack. Coma from a severe injury. And for those who develop Alzheimer’s or dementia, there may come a day when being able to clearly express one’s wishes is no longer possible.
Without having a person ready to communicate and advocate on your behalf, doctors are often left to navigate and referee family members with differing opinions. That not only makes it harder for doctors to doctor, but it also exposes your family to heartache. The fact that you are sick is hard enough for your loved ones.
There is no cost to creating your healthcare proxy. This is one important document that does not need the input of a lawyer. All you need to do is download and fill in free state-specific documents. Making it official typically requires just the signature of two witnesses.
Pairing with an advance directive is smart, but not necessary. Strictly speaking, an advance directive is a separate document (also free, also no need to involve a lawyer) in which you spell out your wishes for the type of care you want if you become too ill to discuss matters with your medical team. Your advance directive is the operating manual your healthcare proxy can follow to advocate on your behalf with your medical team.
(A side note: To complicate matters an advance directive also goes by the name of “living will.” There are other crucial documents to consider, of course.)
In an advance directive you spell out under what conditions you do or do not want specific types of care such as ventilation, resuscitation, a feeding tube, and dialysis. It is also where you can specify if you want to be an organ donor and for what purposes (research, or donation to another person).
Some online resources for downloading a healthcare proxy combine it with an advance directive, given how they work together. That said, if for whatever reason you are struggling with the notion of an advance directive, you can opt to only complete the healthcare proxy. ASAP.
Decide who. You can name your spouse but you are not required to. This really comes down to who you want to be your front line representative communicating with your doctors.
You can name more than one person to be your agent. That might seem easiest if, say, you have two or three children. But having multiple agents adds complexity, as it requires each named agent to agree with the others. You can’t be 100% sure that will happen seamlessly. Sticking with one agent is typically best.
The Conversation Project has a free downloadable Choose a Proxy Guide.
Confirm your choice is willing to serve. An oddity of the healthcare proxy document is that it does not require the signature (confirmation) of the person you have appointed. That makes it possible to name someone, without them knowing it.
Don’t do that. Someone who deeply loves you may not be comfortable making those decisions. Confirm that the person you are thinking of is able to step in if needed. Moreover, that person needs to know what you want. Again, ideally you will also create an advance directive to serve as the proxy’s road map. But if that’s something you need more time to work through, make it a priority right now to have a clear-eyed conversation with your proxy about your wishes.
Download a state-specific healthcare proxy. The National Hospice and Palliative Care Organization provides free forms customized to each state. This organization combines the proxy with advance directive wishes. That said, if you prefer you can fill out just the proxy part. You can find your state’s advance directive instructions on the site.
Another option is to do a quick web search of “healthcare proxy NAME state.” You might need to scroll down past a few commercial offerings (Remember: You do not need to pay for this.) before landing on links for documents offered by your state government, the bar association or medical organizations.
Follow the witness instructions. The person you appoint as your healthcare proxy, caregivers and employees of caregivers typically can’t sign on as the witness. Be careful to follow the instructions for who qualifies as a signatory witness.
Share copies. The person you have appointed needs a copy, as well as your doctors.