Power of Attorney for Health Care: Choosing Your Agent

The selection of an agent under the Power of Attorney for Health Care (POA) should be made with thought and care. The person you choose has a grave responsibility to act on behalf of an ill or elderly individual often under very difficult circumstances.

Some important guidelines in choosing and communicating with an agent include:

1. Name someone you can trust with your life — in fact that is what you are doing.
2. Don’t be afraid of hurt feelings. Choose the individual(s) you believe will serve your interests the best. Consider emotions, but don’t let them dictate the decision.
3. Your agent should be someone you can comfortably talk with about your wishes for care during illness. These conversations are best made “around the kitchen table” and should include conversations about your values. If a prospective agent isn’t comfortable with such conversations, he/she might not be the best choice.
4. Ideally, the agent is someone who can be readily available, and emotionally and intellectually capable of asking questions and of articulating and advocating the individual’s wishes in sometimes unfamiliar or overwhelming situations.

To insure that the POA is used as intended, the agent and all successor agents should have copies of the POA as should the primary physician and a family member or members. To be most effective and meaningful, it calls for an ongoing process of communication between the individual, the agent, family members and caregivers.

During illness and hospitalization, the agent should ask the physician in charge, the “attending physician,” to write an order to “contact the agent for consents for all tests and procedures” in order to ensure coordinated communication among other specialists who may be called in as consultants.

In considering interventions, the agent should consider the ultimate goals of the care. In consenting to tests, it should be clear how the information derived from the test would be used to promote the identified goals of care. It’s very easy, in this age of specialization, to treat the symptom or body “system” and lose sight of the person. The purpose of the agent is to ensure that all decisions regarding tests and procedures are made in the context of the individual and his or her values and wishes.

The Power of Attorney for Health Care is much more than a legal document. It establishes a sacred trust and demands the courage to consider the most critical life and death decisions we all ultimately face, for ourselves and for others.