Why Your Parents Need an Advance Directive and Health Care Power of Attorney

by Cameron Huddleston

Why Your Parents Need an Advance Directive and Health Care Power of Attorney

Contents

    As your parents age, there might come a time when they are no longer able to make medical decisions on their own. It’s so important to know what their wishes are before that time comes and to have a plan in place for someone else to make decisions for them.

    That’s where an advance directive and health care power of attorney come in. These essential legal documents – along with a financial power of attorney – can help you and your parents be prepared if you ever have to care for them and make decisions for them.

    What is an advance directive?

    An advance directive is a general term for a legal document that lets you spell out in advance what sort of medical treatment you do or do not want if you can’t speak for yourself. A living will, for example, is an advance directive.

    It can be used to address a variety of end-of-life care decisions:

    • Whether to allow artificially provided nutrition and hydration
    • Whether to allow ventilation if unable to breathe
    • Whether to allow life-prolonging treatment
    • Whether to allow comfort care and treatment to alleviate pain
    • Whether to allow your organs or body to be donated

    Depending on the state where your parents live, they also might be able to include a do not resuscitate order in a living will or advance directive. However, this can be a separate document.     

    Your parents should discuss end-of-life treatment options with their doctor before specifying what they do or do not want in an advance directive. Also remember that their living will should reflect your parents’ wishes and values, not yours.

    When is an advance directive needed?

    All adults should have an advance directive so there’s no confusion over what their medical care wishes are. It’s especially important that your parents put their wishes in writing before there’s any sort of health care emergency so you don’t have to guess what they want. That could lead to legal battles if you and your siblings or other family members have different opinions about whether to keep your parents on life support.

    Plus, a health care power of attorney can have the power to admit your parents into a hospital or nursing home, to speak with their doctors about treatment and to gain access to their health information that might otherwise be protected by the Health Insurance Portability and Accountability Act (HIPAA).

    To be clear, a health care power of attorney does not have the authority to overrule the directives in a living will. For example, if your parents specify in a living will that they want to be allowed to die naturally but you want them to be on life support, you can’t use your power as their health care surrogate to authorize life-prolonging treatment.

    It’s especially important that your parents name a health care proxy if they don’t want to spell out end-of-life wishes in an advance directive. If they don’t name someone to make decisions for them, someone they don’t want making those decisions could step into the role. A court could even appoint a guardian to make health care decisions for your parents if they are incapacitated.

    What is a health care power of attorney?

    Another component of advance health care planning is naming someone to make medical decisions for you if you are unable to yourself. You can name a health care power of attorney – also called a health care surrogate, proxy or agent – in a living will or in a separate form.

    Even if your parents have an advance directive that spells out what sort of medical care they do or do not want, it’s important for them to also name a health care power of attorney. Not all situations can be anticipated in an advance directive. So they need someone they trust to make any decisions they haven’t already made.

    Plus, a health care power of attorney can have the power to admit your parents into a hospital or nursing home, to speak with their doctors about treatment and to gain access to their health information that might otherwise be protected by the Health Insurance Portability and Accountability Act (HIPAA).

    Even if your parents have an advance directive that spells out what sort of medical care they do or do not want, it’s important for them to also name a health care power of attorney.


    To be clear, a health care power of attorney does not have the authority to overrule the directives in a living will. For example, if your parents specify in a living will that they want to be allowed to die naturally but you want them to be on life support, you can’t use your power as their health care surrogate to authorize life-prolonging treatment.

    It’s especially important that your parents name a health care proxy if they don’t want to spell out end-of-life wishes in an advance directive. If they don’t name someone to make decisions for them, someone they don’t want making those decisions could step into the role. Or a judge could even appoint a guardian to make health care decisions for them if they were incapacitated.

    How to create advance directive and health care power of attorney documents

    Your parents can work with an elder law or estate planning attorney to draft these and other estate planning documents. However, even attorneys say that it’s OK to use a downloadable, fill-in-the blank advance directive and health care power of attorney documents.

    The American Bar Association offers a free health care power of attorney form that is valid in every state except Indiana, New Hampshire, Ohio, Texas and Wisconsin. If your parents live in one of those states, they can check with their state bar association, state department of health or even their doctor to see if a free form is available.

    The American Bar Association also provides links to state-specific advance directive forms. Aging With Dignity offers a Five Wishes advance directive that’s valid in most states for $5. It includes a guide to help with end-of-life treatment decision making.  

    Once your parents have these documents, they should give copies to their health care providers. They also should give copies to the person or people they name as their health care power of attorney.

    [ Keep Reading: What You Need to Know About Being a Financial Caregiver ]

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    Cameron Huddleston

    Cameron Huddleston is the author of Mom and Dad, We Need to Talk: How to Have Essential Conversations With Your Parents About Their Finances. You can learn more about her at CameronHuddleston.com or follow her on Twitter @CHLebedinsky.

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