Appointing a Power of Attorney Agent for Personal Care and Discussing Directives

What is a power of attorney?

A power of attorney is a written, legal document giving a person or organization the authority to make personal care decisions on an individual's behalf if they become incapable of making their own decisions. There are two types of power of attorney: personal care and property. Personal care power of attorney includes health care, medical treatment, nutrition, housing, clothing, hygiene, etc.

A person selected to administer a power of attorney is called an agent, attorney or representative. Appointing a representative is not a decision that should be made lightly. An important step in the selection process is asking the person if they are willing to undertake the task. Prior to any decision-making, it is essential for them to know and understand your health care preferences.

Asking someone to be your power of attorney agent

Your power of attorney agent should be a trusted family member or friend who is familiar with your health care wishes. Tips for requesting someone to be your power of attorney representative include the following:

1. Calmly introduce the topic. Beginning a serious conversation can be challenging. Talking about a loved one’s past experience or a recent news story can help provide context to start the discussion.
2. Remove the focus from death. Some individuals may be uncomfortable discussing being a power of attorney agent if they believe the sole purpose is to make end-of-life decisions. Emphasizing that the goal is to make sure your values and beliefs are followed can broaden the conversation.
3. Discuss making difficult decisions. If you do not wish to have life-sustaining measures, such as cardiopulmonary resuscitation (CPR), mechanical ventilation, and tube feeding, the power of attorney representative must be prepared to express those wishes, despite their own emotions. Ensure they are willing and capable of following your instructions.
4. Express gratitude and trust. Asking someone to be a power of attorney representative is an important decision that can have a serious impact on the agent’s life. Letting them know that they are highly trusted and their service is valued provides reassurance and comfort.
5. Consider choosing a back-up. A situation may arise where a power of attorney agent is unable or unwilling to act on your behalf. Therefore, it may be beneficial to name a second person who can step in if needed.

Discussing your health care directives

It is imperative for a power of attorney representative to know your health care wishes and preferences in order to follow them. This should be done prior to a health crisis. Tips to inform them of your health care decisions include the following:

1. Complete a living will. A living will expresses your wishes concerning life-sustaining measures. A copy should be given to your physician and agent. If you update your living will, be sure they receive the updated copy.
2. Discuss your wishes. While a legal document will likely define certain decisions to be made, ensuring the representative understands your wishes is essential. If they know the reasoning for your choices, they will be better prepared to make unexpected decisions that may not be disclosed in legal documentation.
3. Discuss uncomfortable topics. Health situations can change quickly; therefore, a representative should know if there are any situations in which you would want aggressive life-saving measures, such as life support. Decisions for treatment options, including pain control, surgical procedures, antibiotic use, etc., should be disclosed. Although difficult to discuss, topics should also include organ donation, preferred funeral homes, and cremation or burial wishes.