What Is a Health Care Power of Attorney?

A Health Care Power of Attorney (HCPOA, for short) is a type of advance directive.  It has a few different names, depending on your state.  For example, you may also hear it called a health care proxy or a health care agent.  

A HCPOA is a legal document  that names a particular person to be in charge of future medical decisions.  Many people choose their spouse or an adult child to serve as their health care power of attorney.  Other people choose a close family friend or even a lawyer. The idea is that the person named in a HCPOA will make the same decisions that the patient would have made if he or she were able.

It is against the law for physicians or other health care employees to act as HCPOA for their patients.  For example, Mr. Stone lives in a skilled nursing facility.  He has a favorite nurse, Marsha, with whom he has discussed his end-of-life wishes.  He says he trusts her the most and wants her to be his health care power of attorney.  Marsha knows this is against the rules so she asks the social worker to discuss the matter with Mr. Stone.  The social worker helps Mr. Stone choose an appropriate person to be his HCPOA.

It is wise for people to have both a living will and someone appointed as a HCPOA to make decisions.  The living will provides general instructions and the HCPOA document names the person who will carry out those instructions.

Let’s say that Mr. Smith wants to establish a health care power of attorney.  Who should he choose?  It should be someone who:

• Is trustworthy, knows Mr. Smith well and agrees to represent him.
• Is willing to have a conversation about what Mr. Smith wants and doesn’t want when faced with critical medical decisions.
• Will stand up for Mr. Smith when doctors may be making strong suggestions that he would not want.

It is common for people to select an alternate person to serve as HCPOA—just in case their “first choice” is not available when decisions need to be made.  For example, Mrs. Walters named her daughter as her HCPOA and her son as the alternate HCPOA.

The simplest way to complete advance directives is to obtain the forms and take them to a bank where a notary is usually available.  For people who are in a healthcare facility, the social worker or chaplain may be able to help complete the appropriate documents.

Remember that clients who have completed a HCPOA form have not given up the right to make their own medical decisions.  A HCPOA takes charge only if and when clients are unable to communicate their own wishes.