8 "Next Steps" When You Agree to Serve as Healthcare Agent

8 “Next Steps” When You Agree to Serve as a Healthcare Agent

Mother and son discussing healthcare directive

Photo courtesy: Thinkstock / Fuse

Standing at the kitchen island talking about a recent news story, Bill’s mom casually remarked, “If I were in a coma like that, I wouldn’t want any heroic measures.” Did that statement infer that, if required, Bill was supposed to make treatment choices on his mother’s behalf? He didn’t feel equipped to make such critical decisions.

Has a loved one ever made a similar comment to you?

Too often, in the awkward moment of a conversation, people agree to serve as a healthcare agent, but they’re actually thinking, “That will never really be necessary.” When a medical crisis occurs, lacking any real preparation, panic ensues.

In last week’s post, we explored the responsibilities of serving as a healthcare agent. If you do agree to serve, the following steps are essential to ensure you can serve well.

  1. Clarify whether you are the primary agent or an alternate. Optimally, introduce yourself to the other agent(s) if you are not acquainted.
  2. Determine whether you have final-decision authority, or will be required to reach consensus with other healthcare agents.
  3. Secure a copy of, or online access to, the healthcare power of attorney document that legally names you as the agent. You might need documentation to prove your decision-making authority in the future.
  4. Verify that the Power of Attorney document includes a HIPAA release statement that authorizes you to see the future patient’s medical records, and discuss his or her condition and treatment options with the medical team.
  5. Firmly request that the future patient’s healthcare instructions are recorded in writing as part of an executed healthcare directive. While discussion is invaluable, an executed directive will substantiate your efforts to honor the patient’s preferences.

Note: I recommend having healthcare directive documents stored online, with an access link, username and password stored in your smartphone in the future patient’s contact record.

  1. Recommend a family meeting so together all impacted parties can hear the future patient’s end-of-life preferences. Ask questions and request clarification if necessary. You might reduce future conflict and disagreement if loved ones and agents can all hear and accept the future patient’s wishes.
  2. Request that the executed healthcare directive be included in the future patient’s medical record. Access to treatment preferences through a healthcare directive stored in the electronic medical record is optimal. Work with the future patient—especially an elder—to ensure the document can be accessed in her chart.
  3. Consider attending a meeting with the future patient with his or her healthcare provider. A proactive meeting to become acquainted with the patient’s primary care physician can ensure a higher level of collaboration, should a medical crisis ever unfold.

The role of healthcare agent carries enormous responsibility. Preparation is key. As an informed and equipped healthcare agent, you can advocate for the patient and honor his or her preferences with peace of mind.

Be sure to read next week’s post as the third in this series. I will be sharing suggestions on managing in the midst of a crisis when you are actively serving as a healthcare agent.

If you have served as a healthcare agent, would you have any additional advice to offer?

QUESTION: If you or a loved one have served as a healthcare agent, would you please share your story and inspire others via social media? Please share this post with your comment.



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  1. Further suggestions: I would suggest that your Representee’s (i.e. the person you are healthcare agent for) Advance Directive be comprehensive. Many people fill out simple ‘check the boxes’ directives, without recognizing that most medical decisions (especially with modern medical technology) are not a simple ‘yes or no’/’black or white’. For example, there is more than one kind of feeding tube, used for different purposes and with different advantages and disadvantages. Doing such comprehensive Advance Directives definitely require more depth of discussion (and should be reviewed every 5-10 years), but they draw out the values that a directive would be based on — as well as all of the shades of ‘grey’ that the Representee really intended in their choices.

  2. Thank you for your thoughtful addition, Pashta. Yes, the quality and clarity of the Representee’s healthcare directive is critical to the agent’s ability to successfully advocate for the Representee’s wishes. A values-based directive can guide the agent for decisions that are not specifically expressed in treatment guidelines. And yes, reviewing and refreshing one’s directive every few years is very important.

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