Do You Need a Health Care Proxy?

Have you chosen the person in your life who can make health-related decisions for you in a crisis? Here's how to decide - and how to make it official.

You exercise, eat right and stay on top of your doctor's appointments. Those are smart habits that can keep you feeling your best. But we all know that health emergencies, from car accidents to strokes, can happen when you least expect them.

That's why it's vital to have a health care proxy in place. This is a trusted person you choose to make medical decisions for you in a crisis, when you can't do it yourself. They act as your voice and help carry out your wishes. Having a proxy is a key part of planning for your health future.

Here’s what you need to know about the health care proxy, why everyone needs one and how to set it up.

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What does a health care proxy do?

People usually choose a close family member, like a spouse or an adult child, to be their health care proxy. Your proxy will be able to advocate for you to make major medical decisions as well as end-of-life care when you're too sick to do it, explains Monique Lavender Greenberg. She's an attorney in Coral Gables, Florida who specializes in wills, trusts and estates.

Your health care proxy is legally allowed to talk to your doctors about your medical care and see that your wishes are carried out. The situation most often comes up if you're unconscious or if you're not mentally able to make decisions.

This can be both temporary and on an ongoing basis, says Lavender Greenberg. For example, a proxy may be called upon:

• In a temporary situation: Let's say you're under anesthesia for surgery and the doctor found something they didn't expect. It might require an urgent decision between a, b, or c. while you're still under.
• In a long-term situation: For example, you’ve been diagnosed with dementia, like Alzheimer’s disease, and become unable to make decisions for yourself.

You write down your wishes in a legal document called a durable power of attorney for health care. This is one type of advance directive. (The other common advance directive is a living will.)

And you can change your proxy at any time, according to the National Institute on Aging (NIA). So, even if you've had a health care proxy in place for years, it's a good idea to review it regularly.

What are the benefits of naming a health care proxy?

Going into surgery or living with a chronic disease can come with plenty of unknowns. And that uncertainty can be scary. "A healthcare proxy allows you to take control of a situation you'd otherwise have no control over," says Lavender Greenberg.

You get to talk to your loved one about your wishes in advance. For example, you can let them know if you want your organs donated, or what types of medical procedures you are okay with receiving.

To be clear, by naming a proxy, you still get to be the person in charge of your own health care. It's just those times when you can't that your proxy will step in.

If you don't have a proxy this in place, your next-of-kin (your closest living blood relative, including spouse or adopted family members) may be able to act as your proxy. But the rules about this differ from state to state, says Lavender Greenberg.

That’s why it’s important to name your health care proxy now, when you’re healthy.

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How do I choose a health care proxy?

This is a big responsibility. The American Bar Association and other experts suggest you consider these questions to help you decide:

• Are you comfortable talking to this person about your values and wishes for your health care? Are they a good listener?
• Do you trust this person to honor your wishes when the time comes?
• Do their beliefs align with yours? This may require some frank discussions on your part, points out Lavender Greenberg. "Sometimes people have very different medical beliefs than their next of kin." For example, if the person has religious views that would prevent them from carrying out your wishes, you should choose someone else.
• Is this person able to ask good questions? When someone is in the hospital or in a medical situation, think about the person in your family who does research, asks questions and looks to get a second opinion. This can be a good choice for a health care proxy, says Lavender Greenberg.
• Does this person live near you or would they be able to travel to be with you if needed?
• Could they handle conflicting opinions among family members, friends and doctors?

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Where can I start?

One place to start is by talking to your doctor. Advance care planning is covered by Medicare as part of your annual wellness visit. Your provider can help you fill out a durable power of attorney for healthcare form.

You can find the form for your state online and fill it out for free on your own. Groups like the American Bar Association have online resource centers and toolkits to help, too.

You can also work with a lawyer if you prefer. Bringing an attorney on board who specializes in estate planning can help you avoid hiccups along the way.

While this decision can feel overwhelming, it's impactful and important. "If you think about it, you're giving yourself power by making the decision now," says Lavender Greenberg.

And one final point: Be sure to tell your family member when you name them. Confirm with them that they are willing to act as your proxy, so that everyone can be on the same page.

Recommended reading: 5 Smart Financial Habits It’s Never Too Late to Adopt

See our sources:
Health care proxy basics: National Institute on Aging; American Bar Association
Toolkit for choosing a health care proxy: American Bar Association
Advance directives: National Institute on Aging
Annual wellness visit and advance care planning: Medicare.gov

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