(as seen in CNG publications group Dec, 2013)
The responsibilities of the health care proxy/agent include approving or refusing medical treatments and making health decisions on care for a friend or relative.
Want to know how to insure an aging friend or relative receives the best medical care? Answer: Become her health care proxy. A health care proxy, also called a health care agent is a person who is legally permitted to make medical decisions for another when the friend is no longer able to speak for herself.
As your friend’s health care agent, you can approve or refuse medical treatments for her and make health decisions on all types of care. You can sit in on her medical meetings, decide on special treatments, approve all diagnostic tests and surgical procedures, and even agree or disagree to organ donations.
The health care agent has the authority to make decisions on more than medical procedures. You can insure the health care staff treats your friend with respect and dignity. You can stay in the room when your friend is being bathed or dressed in a nursing facility or at home. In fact as your friend’s advocate it is often a good idea to occasionally stay in the room when an aide is attending her. In this way you can note if your friend is developing bedsores or bruising, and if so, that they are reported and treated.
A friend can appoint you as her agent by filling out a legal document called a Health Care Proxy. The only major requirement to becoming an agent is to be competent and be 18 years or older. The role can be activated either in a temporary situation, as in the case of surgery, or in a long-term situation, such as if your friend develops dementia or enters a coma. To insure that there is no abuse of power, only a doctor can determine when an individual lacks mental capacity to make her own decision and when an agent’s role can be activated.
A health care agent does not have to be a family member. In fact, a person may prefer to appoint a friend, especially if she believes her family’s values clash with her own. For instance, if your friend does not want to be resuscitated or put on life support and her family’s religious beliefs conflict with this desire, it is better to find someone with similar beliefs.
More than one person can be appointed as an agent but there should be a hierarchy for decision-making so there are no conflicting disputes. One person should be the prime decision maker with a back up person in case the first individual is not available. In addition the agent’s role does not have to be permanent. In fact, a person can change the designated appointee at any time. This insures if either person has a change of heart or disagrees, the beneficiary can seek another person to represent her.
One important part of your role as agent is to understand your friend’s fundamental beliefs. Before you agree to take on this responsibility, you should learn how your friend feels about such important issues as artificial nutrition and hydration and life support.
The health care proxy is one of the easiest documents to obtain and activate. It can be downloaded for free by logging on to New York Department of Health’s website. You do not even need a lawyer. The only requirement is that two adults must witness you and your friend signing the form.
Once the proxy is signed, you should make several copies. You should keep one copy, give one to your friend, and others should be distributed to all your friend’s physicians and lawyers. If your friend enters a hospital, the attending physician and nurse should be given copies, and if your friend is assigned to a nursing home or rehabilitation facility, the staff of that institution should have copies as well.
The health care proxy is one of several documents categorized as Advanced Directives. These directives refer to any instructions about health care. Two other important directives include living wills, and financial power of attorneys. A living will outlines specific medical measures that are to be taken under specific circumstances. It can indicate a person’s medical preference even though it cannot possibly cover all questions. The financial power of attorney appoints a person to oversee financial, legal, and other matters. The health care proxy is only good for medical situations.
If no one is appointed as a health care agent, state law determines who can make health decisions. Many states, including New York, allow a hierarchy of decision makers to determine who to consult. It usually starts with a court-appointed guardian if one has already been assigned to an incapacitated adult. Next in line is the spouse or domestic partner, then a child over 18 years old, then a parent, then a sibling over 18 and finally a close friend or relative.
In any case, the health care agent is one of the most powerful advocacy positions a person can be assigned. It offers you the opportunity to represent a loved one when she is no longer able to speak for herself. It is an important way to be able to insure that your friend is treated with the dignity that she deserves.