Bam! – You Are Now A Healthcare Surrogate
Your loved one or friend has named you as their healthcare surrogate; the individual who will authorize medical care and treatment, and make all necessary healthcare decisions should the loved one become incapacitated due to illness. This role comes with extensive responsibilities, to ensure that you are acting in accordance with the individual’s wishes and in their best interests. You need to think not of your wishes, but what your loved one would want. If you have any reservations or concerns about performing the role, the reservations must be addressed promptly. Your loved one must have peace of mind knowing that whomever they appoint as their healthcare surrogate will act in their best interest, and do so with no reservations.
It’s Not About You
It’s not about the healthcare surrogate; it’s all about ensuring the best interests for your loved one. Always try to look at things through your loved one’s eyes. Don’t just do what you would do if you had this illness or condition. Don’t let your distress about what is happening with your loved one result in you tell the doctors to do something that you know your loved one would not want.
Think about their medical condition, and how they would want to be treated. Hopefully, you have discussed their wishes and preferences before a crisis situation surfaces, so you already know what are your loved one’s preferences.
Realize that there may be another representative appointed to address the non-healthcare and financial interests of the loved one. Critically consider if you can work collaboratively as healthcare decision maker with the other individual named to protect the financial welfare of the loved one. A disservice will be done to the loved one when the healthcare and financial surrogates cannot collaboratively ensure that the loved one’s wishes are followed.
Be Prepared For The Role
At the time of being named as a healthcare surrogate, you need to know your loved one’s medical status.
- Discussed your loved one’s wishes and have a clear understanding of their end-of-life preferences
- Have a copy of the Healthcare Surrogate form
- Named on HIPAA Privacy Notices that the loved one has completed at each of their medical providers
- Does the person have any ongoing medical issues, such as chronic conditions?
- Does the person have any allergies (to medicines or to other things)?
- Is the person currently taking any medicines or receiving any medical treatments? What medicines or treatments and for what purposes?
- Are there any drugs or medical treatments that the loved one would prefer not to receive, and why?
- Meet/get to know the financial surrogate if applicable. Exchange contact information
Many times the healthcare surrogate assumes the role to address end-of-life care. This typically happens when there is a crisis situation and quick decision making is needed. This is the time when knowing and following the loved one’s advanced directive and planning wishes takes center stage.
- Does your loved one care more about living as long as possible (even if that might mean some physical discomfort), or being as comfortable as possible (even if that might mean a shorter life)?
- Does your loved one want to be at home at the end-of-life, or would the loved one prefer to be in a hospital or professional care setting?
- Does your loved one have religious or spiritual values that will affect the types of care or treatments he or she would like to receive?
- Are there specific life-support treatments that your loved one knows he or she would like to receive or would not like to receive?
- Would your loved one like to have a palliative care team or hospice team care for him or her at the end of life?
- Are there other wishes that should be observed as your loved one nears the end-of-life, such as calling a religious leader to come visit the person, having certain music playing, or having certain friends or family members in the room?
The Job Description
Key responsibilities and duties of the healthcare surrogate (there is always something else you may have to address). There may be some modifications to the role based on State statutes; the following is a general guide:
- Make decisions that are in accordance with your loved one’s wishes including religious and moral beliefs, if those wishes are known
- Make decisions based on the patient’s best interests, if the patient’s wishes are not known
- Diligently consult with physicians and other health care providers regarding medical care, including medical tests, medicine, surgery or end-of-life care
- Provide informed consent on in matters of medical intervention
- Apply for Medicare, Medicaid, or other programs or insurance benefits on your loved one’s behalf to help pay the cost of health care
- Manage the admittance to or transfer from health care facilities, including hospitalization, rehabilitation center, nursing home, home health care or hospice
- Authorize access to your loved one’s medical records for healthcare decision making
- Authorize release medical records to third parties
- Authorize decisions regarding autopsy, organ and tissue donation
- Request or decline life-support treatments
- Choices about pain management, including authorizing or refusing certain medication or procedures
- The option to take legal action on the person’s behalf in order to advocate for his or her health care rights and wishes