By Theresa Pichelmeyer, EdD, RN, President and CEO of Valley VNA Senior Care
National Health Care Decisions Day is April 16, a day set aside to educate and empower people and their family members about the importance of advance care planning. The Power of Attorney for Health Care, or POA-HC, is a document that any adult, age 18+ (the “principal”) completes and signs, naming another individual (the “agent”) to make one’s health care decisions when the principal might become unable to make those decisions for him or herself.
Most people never plan on becoming incapacitated. Many think a POA-HC is just for old people. However, every adult should think about a few situations where they, at any age, might need a POA-HC: a car, ATV, or snowmobile accident that leaves you in a coma; a prolonged bad reaction to a drug; an injury sustained in a violent crime; or a life-threatening event, like a stroke or progressive disease. Therefore, all adults, or a loved one who is becoming an adult, needs a POA-HC.
There are several important reasons why every adult, age 18 or older, should complete a POA-HC. The “next of kin” idea simply does not apply in modern times. In Wisconsin, a family member is not automatically authorized to make health care decisions for an adult relative unless he or she completes a POA-HC document naming that person as one’s agent. Secondly, it’s not just about end-of-life care. Hopefully the sick or injured person will recover from his or her health crisis. The POA-HC is about receiving the care one needs and wants when he or she can’t speak for oneself. Also, a person’s family may have to go to court to appoint a guardian without a POA-HC in place. This process can be costly, time-consuming, cumbersome, and emotionally draining. And then, a court-appointed guardian may not be the person the principal would have chosen. The appointed person may have no idea of the person’s wishes or what care he or she might or might not want.
Every adult should choose his or her agent carefully. A person’s health care agent, upon being activated, might make some very important decisions regarding choosing a doctor, treating a medical condition, managing pain, maintaining or refusing artificial hydration and nutrition, and consenting to or refusing surgery. Principals should be confident that their agent will follow their wishes. An agent should be able to resist pressure to influence a person’s choices from friends and family. Nor should the agent make decisions about a person’s care according to his or her own ideas. An agent should be capable of dealing with hospitals, doctors, and stressful health care situations and understand the choices surrounding the principal’s particular injury or condition. A health care agent should be assertive. He or she should be able to ensure that the principal is being treated properly and insist on full, open, and transparent communication with his or her care providers. A chosen health care agent should live nearby or be willing to travel if needed.
To be deemed incapacitated, two physicians must personally examine you and certify that a person can no longer receive, evaluate, and communicate his or her health care wishes. All adults should rest assured, despite creating the document, they keep their right to make their health care decisions as long as they are able. They can also update their POA-HC at any time to change their agent or add specific instructions. If a POA-HC is activated and a person regains his or her ability to make health care decisions, the POA-HC can be rescinded.
How to Prepare and Submit a POA-HC