The Gift of Caring for Others

Few decisions are as personal and as protected as our health care. A health care durable power of attorney is a key element in any estate plan because it lays out thoughtful, clear instructions for when we can no longer make those personal decisions for ourselves. Many of us will be called upon to follow another individual’s instructions and serve as their patient advocate. Will you be ready to serve as a patient advocate? Here are some points to consider:

1) Read the health care power of attorney and the acceptance of appointment form. Determine whether you will act alone, jointly or sequentially.

• • • If acting jointly, you must make either some or all decisions together with the other patient advocate. Ask yourself, will you be able to make decisions with that person?
    • Even if two patient advocates are listed, you may have the power to act alone. For example, “I designate A and B, and each of them, acting alone, as my patient advocate.”
    • Another option is a sequential list, such as “If A is unable or unwilling to act, I designate B as my patient advocate.”

2) Discuss the provisions in the health care power of attorney with the individual to ensure you fully understand their wishes.

• • • Anatomical gifts – Does the individual wish to donate organs upon death?
    • Funeral arrangements – Does the individual wish to be buried or cremated? Where will the body be buried? Where will the cremains be interred? Have arrangements been prepaid?
    • Decisions regarding care and custody – If necessary, did the individual indicate that you can make future decisions regarding where he or she will live? If you live out of state, you need to decide if acting as a patient advocate is feasible, especially if long-term care is involved.
    • Health Care Declaration – What does the individual want you to do if he or she falls into an irreversible coma? A terminal condition without any chance of recovery? Does the individual wish to remain on life support or discontinue this support?

3) Review the HIPAA provisions and determine if there is a “stand alone” document giving you authorization to communicate with doctors and be privy to the individual’s medical records.

• • • Medical records – You are only authorized to act when the individual is unable to make medical decisions. However, you may need to review the medical records and be part of the discussion with the treating physician or mental health examiner at the point in time when they determine the individual is unable to give informed consent to treatment. Be certain that the document provides you with the ability to obtain these records in order to avoid unnecessary delays.

Understand that the individual who designated you as their patient advocate may revoke that designation at any time. Similarly, you may revoke your acceptance of the designation at any time. If you intend to revoke your acceptance, you should communicate accordingly with that individual so they can decide to designate another patient advocate. For more information on serving as a patient advocate, feel free to contact David Mammel at Chapman Law Group at (248) 644-6326.