Your Spokesperson – Your Champion
Who will speak for you?
Designating someone to serve as your representative to make healthcare decisions for you, if you are unable to make them yourself, is an important activity. The designation of this role is a key component of Advance Care Planning (ACP). Determining who that champion of your medical decision making should be when you are incapacitated requires some thought. Often a spouse or partner is the obvious choice. Hopefully, these individuals know your wishes and will do whatever it takes so that your wishes and interests about medical care, treatment, or no treatment will be honored. In the absence of a spouse or partner, consider naming your adult child or a trusted friend for the task. Remember, whomever you choose to serve as your healthcare surrogate/proxy, they will be an integral part of your circle-of-care.
When no one can speak for you…
In the absence of a named healthcare surrogates, healthcare power of attorney, or healthcare proxy (similarly known documents) most states have a hierarchy of who will take the responsibility for making your healthcare decisions. A guardian may be appointed by the Courts in the absence of a family member or trusted friend who knows your wishes. A guardian may also be appointed in the event that there are concerns in how the healthcare surrogate is making decisions relating to your healthcare needs. Typical situations where guardians are named include the healthcare surrogate not following your wishes or making decisions that are not in your medical best interest.
A healthcare surrogate has been identified
Once you have identified the individual who will be serving as your medical champion, verify that they are willing and able to take on this responsibility. Once you have their confirmation that they are willing to take on the role, it is necessary to complete the appropriate forms designating your wishes. Healthcare surrogate/proxy forms can be obtained free from your physician, hospital, State Agencies, or may be obtained from an attorney as part of your Advance Care Planning packet for a fee. Most states require that the forms be notarized.
What to do once the surrogate has been identified:
- Inform the individual that they have been named and get their agreement to be the surrogate
- Provide a copy of the form to the healthcare surrogate/proxy so that they can present it in an emergency to help in ensuring your wishes are respected
- Provide the healthcare surrogate/proxy’s name and the individual’s contact information to all your healthcare providers
- Add the Healthcare surrogate/proxy to Privacy Notices that you are asked to complete and acknowledge with medical providers. Without this information, they may be unable to communicate your medical condition and information on your behalf
- Keep that healthcare surrogate/proxy’s name and contact information with you in your wallet and provide with any medical reports or information
- Keep a copy of the Healthcare surrogate/proxy form readily available; do not place it in a safe or bank vault that might not be accessed in an emergency. The form must be handy in the event of a medical emergency. Some individuals keep a copy on their refrigerator, a common location that EMS will check for such documents
- Upload your healthcare surrogate/proxy document to your state’s registry (if available)
The healthcare surrogate can be changed
The designation of a healthcare surrogate/proxy may be changed. This can occur if you feel that the initially appointed individual is not able to act in your best interest, or is no longer able to fulfill the role. If that is the case, you will need to thoughtfully identify a new healthcare surrogate/proxy, complete new a new form, and diligently go through the steps with your providers to update the surrogate designation and privacy forms. The outdated contact information and forms should be removed from wallets and replaced with the new information.
A future blog post will address the role of the healthcare surrogate.