Sandra W. Reed: Making medical decisions for someone else — know what you’re getting into

By Sandra W. Reed

You’re the Agent on a Medical Power of Attorney; What On Earth Does It Mean?

If someone asks you to be listed as their agent on their Medical Power of Attorney, you do not have to do so. Before you say “Yes,” you should know what you are getting yourself into.

Attorney Sandra W. Reed answers your life planning questions.

Attorney Sandra W. Reed answers your life planning questions.

The Medical Power of Attorney Makes You the Decider

You, as agent of a Medical Power of Attorney, are required to make the medical decisions that person would make for himself or herself, if he or she were able. The Medical POA gives the agent the right to access to all the information that would be available to the patient, including all the patient’s medical records.

You have the right to consult with the medical team treating the patient so you can understand fully the patient’s medical condition and the treatment options. It is your right to seek second opinions or consultations with different doctors.

The Medical Power of Attorney Does Not Make You Financially Responsible

You are not putting yourself at financial risk by agreeing to be named as an agent in a Medical POA, although money issues may be involved in the decision-making – especially if insurance does not pay for certain treatments – you will not be called upon personally to pay the bills. Only the patient’s and the insurance carrier’s money will be liable.

Before Signing Up, Communicate While There is Time

Waiting until a crisis has occurred to discuss what medical choices the person granting the POA would make, is waiting too late. Before signing up for this duty, obtain a sound assessment of the wishes and the values of the person granting the power. The basic question is, what would the person want done given the circumstances? The individual’s personality, religious beliefs and personal values will likely dictate decisions. It will not be possible to cover every possible scenario, but you need enough information regarding all these factors, plus knowledge of how the person has arrived at prior decisions, to act appropriately in your capacity as agent.

One way to determine the individual’s wishes is to have a frank discussion with the person about how he or she would like to live out the end of life. You should not make the medical decisions based upon what you would choose for yourself unless those choices coincide. Instead you must put yourself in the patient’s shoes and speaking as the patient would speak if capable.

Once on Board, Take These Steps in Making Medical Decisions

  • Get the Facts: What is the medical condition? How severe is the condition and what are the treatment options? What are the likely results? What is the current condition, what course is it likely to follow and what is the prognosis? What will likely benefit the patient the most? If the precise condition is not known, what are the possibilities and what tests are necessary to diagnose? Determine the results and risks of each test. Decide if the information provided will be worth the risk.
  • Determine What “Success” Means For Each Option: Compare what the doctors report as “success” with what you believe the patient would consider “success.” Determine as precisely as possible what increased abilities or functions this particular patient can expect to have following treatment. Determine the likelihood the patient might die while undergoing the treatment or procedure.
  • Determine What Post-Treatment Care Will Be Needed: Discuss with providers the recommended care following the treatment or procedure. Determine whether this involves hospitalization, in-facility or out-patient rehabilitation or home health care.
  • Determine to the Best of Your Ability What the Patient Would Decide, If Able: If you have had the recommended conversations with the person granting the POA, your ability to make this determination as the patient will be greatly enhanced. If you have not had these conversations, consider all you know about the personality, religious beliefs, values and prior decision-making processes of the patient. If you don’t know how the person would decide, make the decision based upon the best interest of the patient. To do that, consider what a reasonable person under the same or similar circumstances would do for himself or herself.

Navagating Within the Health Care System

Your initial role within the health care system is to make certain that any advance directive as to preferred medical services the patient has signed is in the file, included with the chart. Obtain from the patient a copy of any directive in advance to provide in case the directive is not included. You have a duty to remain informed of the patient’s condition. This means you need to be present regularly at the treatment facility and visible to the treating staff. It is important not only to listen but to make yourself heard.

You should keep a record of the medications prescribed so you will know if they are not being appropriately administered. Prepare yourself to be an advocate for the patient. If doctor’s recommendations or health care professionals’ actions are confusing, speak up. Remaining silent is not in the best interest of the patient. It is important to be tactful but assertive.

Time with physicians will be limited. List questions prior to an anticipated visit. Take notes as the doctor answers. Above all, make certain you understand what you are being told. Don’t be afraid to ask questions. It may be advisable to bring in another family member or friends or clergy to provide additional pairs of ears and eyes Misinformation can be worse than no information.

Consult with others in making decisions, only if the persons consulted are as concerned and as trustworthy as you are. You are the chosen one, designated by the patient as the ultimate authority.

Sandra W. Reed is an attorney practicing in Glen Rose, of counsel with the Fort Worth elder law firm of Katten & Benson. Phone: 254-797-0211; email: swreed2@yahoo.com

 

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