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Being a Healthcare Proxy

A healthcare proxy is someone who represents a person who can’t speak for themself. The name of this role varies by state. It may be called a Durable Medical Power of Attorney. It may be called a Durable Power of Attorney for Healthcare. It may be called an agent, surrogate, or advocate. Or it may be called a representative or decision maker. It's an official duty that is noted by a legal document. The document also varies by state. The person must name you as his or her proxy on the document.

A healthcare proxy speaks for another person when he or she is not able to do so. The proxy helps make sure the person’s healthcare wishes are known and followed.

What it means to be a healthcare proxy

Your role as healthcare proxy starts when the person can’t make medical decisions. This assessment can only be made by a licensed doctor. You then make the healthcare decisions as needed. You do this by carrying out the person’s wishes. These wishes are noted in his or her advance care planning documents. These declare what kind of treatment the person wishes to have or not have. You may need to put aside your own values and opinions to carry out the person’s wishes. This may include refusing or stopping life-sustaining treatments.

Documenting end-of-life wishes

As a healthcare proxy, encourage the person to discuss his or her wishes, while they are able. They can do this with their healthcare provider and then document the wishes as a medical order. The provider can help the person complete the form. The forms are known by different names depending on the state. The form may be called one of these:

  • MOLST (medical orders for life-sustaining treatment)

  • POLST (physician orders for life-sustaining treatment)

  • MOST (medical orders for scope of treatment)

  • POST (physician orders for scope of treatment)

  • TPOPP (transportable physician orders for patient preferences)

The form documents the person’s wishes at the end of life. It's not tied to a certain healthcare provider or facility. It's different than a living will. The form is an order written according to state regulations by a healthcare provider. To complete one, the person must express his or her wishes to an advanced healthcare provider. If the person can’t make his or her own decisions, then this is done by the person’s healthcare proxy.

Carrying out your role

Your duties depend on what the person’s advance care planning documents say. Your duties may also depend on state law. In general:

  • Before accepting a role as a proxy, talk with the person. Be sure you know his or her wishes. Ask questions. This will help you be his or her voice if and when it is needed.

  • Be sure that the person’s healthcare team knows that you are his or her proxy. Carry a copy of the document and proof of your identity.

  • Make sure the healthcare team has a copy of the advance care planning documents.

  • Talk to the healthcare team. Ask questions as often as you need. Stay informed about the person’s condition.

  • Ask for any help you need to understand the medical situation. Ask about the person’s condition and prognosis. Ask about risks and benefits of tests and treatments. Find out all the facts and options.

  • Speak on the person’s behalf with the healthcare team when needed.

  • Talk with family members and keep them informed.

  • Know your rights. You have the right to ask for information. You can ask for consultations and second opinions. You have the right to request or refuse treatment for the person. You may be able to review his or her medical chart. You can authorize the person’s transfer to another facility. You can also request a new healthcare provider for him or her. If you are not sure what your rights are at any time, ask a legal advisor.

When it’s time to make decisions

If the person’s wishes are clear in the advance care plan documents, ask for them to be carried out as noted. If they are not clear, talk with the healthcare team. Listen to the team’s recommendations. Talk with a spiritual advisor or counselor. It may be hard for you to make a decision at times. You may feel sad or upset about a decision. Being a healthcare proxy is not an easy role. But it's an important one. Remember that the person trusts you to carry out his or her wishes.

If you need help

  • Ask the healthcare team if you have trouble with a decision. The healthcare team will help you.

  • Encourage the person you are helping to have a conversation with their provider about their end-of-life wishes. The provider can help them fill out the form.

  • You may need help in resolving family conflicts. Ask the hospital or clinic social worker, ethics consultant, or a spiritual advisor for help.

  • If you are having trouble talking with the healthcare team while the person is in the hospital, reach out to the patient relations department. Or ask to speak to the hospital ombudsman or ethics committee.

Online Medical Reviewer: L Renee Watson MSN RN
Online Medical Reviewer: Steven Buslovich MD
Online Medical Reviewer: Wanda Taylor RN PhD
Date Last Reviewed: 9/1/2019
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