Health Care Proxy - When Do You Need One?

A health care proxy is a person that a patient chooses to make health care decisions on their behalf in the event that the patient is unable or prefers not to make the decisions for themselves. A health care proxy also called a Health Care Power of Attorney, is a document that is drawn up specifying who the patient chooses to act as their health care proxy and is signed by both the patient and the person chosen. Forms are available at most hospitals, clinics and doctors offices or can also be drawn up by a lawyer.

Once the document is signed, the patient is continues to make their own health care decisions as long as they are able to do so. If something happens that causes the patient to be unable to make medical decisions then the health care proxy can step in. It allows the patients wishes to be followed even if the patient is no longer able to express what those wishes are.

The problem with a Health Care Proxy is that you never know when you may need it. That is why it is a good idea to do them even if you are young and healthy. God forbid you are suddenly struct with a major illness or involved in some form of horrific accident. It may then be too late to appoint someone.

No one likes to discuss these issues. They seem to make everyone uncomfortable. But you should make sure that you do discuss them before you need to. Pick your spouse, a parent (if you're younger and your parent is still able to perform these duties), an adult child, or close friend and sit down and have a serious conversation. You don't want to just appoint someone and not discuss it with them. You need to make sure that your health care proxy knows and understands your wishes.

Health care proxy forms vary. There is not one standard health care proxy form used by everyone in the US. But they are very similar to each other as they are a legal document.

Obviously first it will declare who the patient is that is appointing the health care proxy as well as the person being appointed. It also usually allows for you to appoint an alternate in case the person appointed is not able to perform the duties of health care proxy at the time you need it. You can actually appoint more than one health care proxy if you choose.

Say you have two adult children and they live in separate areas of the country. If you visit both children regularly you mayu wish to appoint them both so that you are covered in either area. Or you may just want them to make decisions jointly.

There is also a place to indicate if you wish the health care proxy power to end at any certain date. Usually they are in effect until the patient chooses to revoke them. A person may appoint a spouse and then they end up divorcing. Obviously they will most likely revoke the health care proxy once divorced. But a patient may also just want a health care proxy for a certain time period. For example, maybe they are having a major surgery and they only want a certain person to be the health care proxy during that period. It's not common but it can be done.

There is usually a section to indicate your wishes on certain things such as organ and tissue donation and DNR (do not resuscitate) wishes. It also has a section for you to write in any specific wishes that you may have. If you have any religious beliefs that may affect your medical decisions or any other wishes they can be written in.

Then the form is signed by both the patient and the health care proxy as well as a witness. The witness can be anyone over 18 who is of sound mind and is present to know that the patient is voluntarily signing the health care proxy form and the health care proxy is agreeing to accept that responsibility.

The health care proxy comes in when a patient is deemed unable to make decisions for themselves. They may be completely incapacitated and unresponsive, or they just may not be able to make decisions. My grandmother is 96 and is starting to have a hard time making her brain work right. Any decisions, especially medical ones are difficult for her. She still lives alone and takes care of herself (with a lot of help from family) but she doesn't make medical decisions. She relies on her health care proxy.

A health care proxy can make decisions such as whether or not to put in or remove a feeding tube, or other things that are keeping a patient alive. Their decision should stem from their knowledge of the patient's wishes. This should not be what they want or think. If the patient made their wishes known on the health care proxy form then the health care proxy must follow those wishes. They cannot make changes to the patient's wishes.

Other than if the patient's wishes are spelled out on the form, the health care proxy is able to make any medical decisions that may arise. But this is why it is so important to talk these things over prior to finding yourself in the middle of a situation. The health care proxy should be making these decisions based on the patient's wishes. If they don't know the patient's wishes it becomes more difficult.

A health care proxy is not legally or financially liable for decisions made on behalf of the primary individual as long as they take into account the primary individual's wishes and beliefs.

A few months ago my great aunt became very ill. I had been her primary care giver for the past 5 years as she had no children and her spouse died twenty years earlier. She had appointed me her health care proxy a few years back when she had been hospitalized with a serious condition. Thank God we had those papers from that incident.

She reached a point that the circulation in her legs was so poor that not only could she no longer walk but she was in extreme pain. She began also losing her mental status very quickly and they rushed her to the local hospital. From there they sent her to a nearby larger city because they wanted to amputate both legs.

My great aunt was 89 years old and had several other health issues as well. Her husband had both legs amputated prior to his death and she knew what that meant. She didn't like to discuss medical issues or her death but she had made it clear to me that she did not want them to amputate her legs.

Many times she had said to me "Don't let them take my legs." If I was not present and if I did not have the health care proxy form they most likely would have performed surgery to remove her legs. I don't believe she would have survived that surgery. Unfortunately the choice to not remove the legs also made it impossible for her to survive either. She died a couple weeks later.

Although it was sad, I am glad that I was able to make decisions for her when she was unable to so that the end of her life was as she wished and not as the medical community decided.

You shouldn't wait until you need a health care proxy to appoint one. Choose who you think would be good at making decisions on your behalf and discuss your wishes with them. Make sure that they are willing to follow thru with your wishes. Either go to a lawyer, your doctor or obtain your own form. But make sure you complete it correctly. Then you should keep a copy, the health care proxy should keep a copy, and a copy should go to your primary doctor. Hopefully you will not end up needing to use it.