Choosing a healthcare power of attorney agent

Your healthcare power of attorney (HCPOA) agent, or sometimes called a proxy or surrogate, is an individual you trust to speak for you when you are unable to voice your own decisions, such as if you’ve had an accident, are in a coma or unconscious, or have dementia.

In such circumstances, doctors need someone who knows you well and has had conversations with you to guide them in terms of the care or medical procedures you would or would not want.

The “platinum rule.” When selecting someone to fulfill this role, you want them to follow the platinum rule: “Do unto others that which they would want to be done to them.” Regarding life support, you want your HCPOA agent to represent your wishes separate from what they would want for themselves:

• Would you want to be put on a ventilator (breathing machine)?
• Would you want tube feeding?
• Would you want CPR?

A lot of conversation is required about medical care, quality of life, and even what is a “good death” from your point of view. Your HCPOA agent needs to know what your priorities would be if the result of a procedure might be life with less quality (e.g., only 11%–28% of older adults survive CPR, and 30% of them end up with brain disability).

The duties of an HCPOA agent are often short term and in hospital settings. But in the case of dementia, these duties could last for months or years and involve long-term care choices. Beyond someone who understands your values and quality of life priorities, you want an individual who is comfortable talking with doctors and asking questions, and who is persistent and will advocate for your wishes if there is pushback. Also a person who has a steady head during a crisis and can communicate well with your relatives. They don’t have to live close by, but they do need to be available by phone. You must name them in your advance healthcare directive, and they must agree to take on this role! A HCPOA agent is not effective immediately, unless otherwise stated in the document. It becomes activated when medical professionals deem you incapacitated.

You can choose a succession of decision-makers so someone else is prepared in case your first choice is not available. Having two people share the role, however, is not recommended. It can stall a decision that needs to be made quickly.

If you are a “solo ager” (no children). Most people pick a younger family member. (Peers may not be available because of their own health challenges.) If you do not have younger relatives you want to entrust with this responsibility, Sue is certified by Respecting Choices? First Steps? as an Advance Care Planning Facilitator and can assist you in completing the document. She is also a member of the Fox Valley Advance Care Planning Partnership in Appleton, Wisconsin.

Do you want help determining your HCPOA agent?

Give us a call at 920-740-8441.

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