What Is A Healthcare Proxy?

When caring for a family member, a critical aspect of your caregiving plan is selecting a reliable person to act as your healthcare proxy. This means someone who can make medical decisions if you cannot. It's crucial to understand what a healthcare proxy is, who can take on this role, how to choose the right person, how to designate them officially, and what follow-up steps are necessary to make sure everything runs smoothly in the future. 

What is a healthcare proxy?

A healthcare proxy, known as a healthcare representative, agent, or surrogate, is someone you authorize to make medical decisions if you become incapacitated. This person works with your doctors and healthcare providers to ensure treatment follows your preferences.

Family caregivers should choose a healthcare proxy so their loved one's medical decisions align with their wishes. In times of incapacitation, a trusted proxy makes important healthcare choices, relieving the caregiver's burden and guaranteeing the patient's best interests are protected. It offers peace of mind and clarity in difficult situations.

You formally name your proxy in a document called an advanced health care directive or durable power of attorney for healthcare. This authorizes them to step in when you cannot convey your wishes.

What does a healthcare proxy do?

If you're a family caregiver looking after an aging loved one, choosing a healthcare proxy can be a matter of life or death. This person will have significant responsibilities, such as making medical treatment decisions, selecting care providers and facilities, accessing medical records, and even deciding on organ donation or autopsy. 

In some cases, they might become a legal guardian if the court appoints them to do so. Your proxy should consult with you whenever possible and follow your documented wishes. It's essential to ensure that your chosen proxy fully comprehends these duties and is willing to carry them out. 

Your doctors can also educate your proxy on their role to prepare them for these vital responsibilities.

Who is eligible to be a healthcare proxy?

Here are the basic requirements for who you can select as a healthcare proxy:

• Must be 18 years or older (19 in some states)
• Should be of sound mind with the capacity to make complex decisions
• Often a family member but could also be a close friend, neighbor, or lawyer
• Cannot be your attending health provider or an employee/owner of your treating health facility

Think carefully about who will understand your values and honor your preferences. Proximity may be necessary if they need to visit you frequently.

How to choose the best healthcare proxy

Choosing the best healthcare proxy is a critical decision, as you are essentially handing them the responsibility of making medical decisions on your behalf or on behalf of a loved one in case you cannot do so. Here are some key factors to consider when selecting your healthcare proxy:

1. Comfort discussing medical wishes: Your healthcare proxy must be someone with whom you can have open and honest conversations about your medical preferences. They should be willing to listen to your wishes and advocate for them, even if they may differ from their own beliefs. For example, in the conversation about what to do if your heart were to stop, do you want all life saving measures attempted? Or do you want to be a Do Not Resuscitate (DNR)? These are tough conversations but are important before something traumatic happens.
2. Alignment of beliefs: Your healthcare proxy should share your values and priorities regarding your health or that of your loved one. This alignment is crucial to ensure your decisions align with your beliefs and wishes. Discussing end-of-life care, resuscitation, and other sensitive issues can confirm that you share similar perspectives.
3. Trustworthiness: Trust is the foundation of a healthcare proxy relationship. You must be confident in your chosen proxy's ability to honor your decisions and act in your best interests. Trust is essential in emotionally charged medical situations.
4. Conflict management skills: Medical decisions can sometimes lead to disagreements among family members or with healthcare professionals. Your healthcare proxy should have effective conflict management skills. They should be able to navigate and resolve conflicts diplomatically while ensuring that your wishes are respected.
5. Geographic proximity: It is often practical for your healthcare proxy to live reasonably close to you or your loved one. Proximity is important because they need to be actively involved in medical decisions and able to visit hospitals or healthcare facilities when necessary. This physical closeness allows for a more hands-on approach to your healthcare.
6. Medical knowledge (optional): While not a requirement, having a healthcare proxy with medical knowledge can be beneficial. Such individuals may have a better understanding of medical procedures, terminology, and the potential implications of different treatments. This knowledge can help them make more informed decisions or communicate effectively with healthcare professionals.

How to officially designate a healthcare proxy

Formally designating your healthcare proxy is a crucial step in ensuring that your medical wishes are honored when you cannot communicate them yourself. To make this official, follow these  steps:

1. Use your state's standard advance directive form: Most states provide standard advance directive forms that make designating a healthcare proxy straightforward. These forms are legally recognized and ensure that your wishes are properly documented.
2. Witness signatures: When completing your advance directive form, it may require the signatures of witnesses. Ensure that you adhere to your state's specific requirements for witness signatures, as these may vary.
3. Notarization (if required): Depending on local laws, notarization of your advance directive may be necessary for it to be legally valid. Verify the requirements in your state and, if needed, have the document notarized.
4. Distribution of original signed forms: Provide the original signed documents to your appointed healthcare proxy, your doctor's office, and the hospital where you anticipate receiving medical care. This ensures medical professionals recognize your proxy's designation during a healthcare crisis.
5. Access to other documented wishes: Grant your healthcare proxy access to any other documents or files that outline your care preferences. This may include living wills, do-not-resuscitate (DNR) orders, or medical history records. Access to this information equips your proxy with a more comprehensive understanding of your medical wishes.
6. Maintain copies for emergencies: Keep copies of your designated proxy paperwork readily accessible. In an emergency, these copies allow your proxy to demonstrate their legal designation quickly. Store them in a secure and easily accessible location. Physical copies should be on hand when heading to the hospital with your loved one. If something happens and your loved one becomes incapacitated, you can present the paperwork and begin making medical decisions for them.

Additional steps after designating a healthcare proxy: 

1. Provide contact information: Ensure that your healthcare proxy has access to the contact information of all your healthcare providers, including primary care physicians, specialists, and any medical facilities you regularly visit.
2. Inform healthcare providers: Notify all your healthcare providers about your designated proxy. Provide them with your proxy's name and contact number so they know who to communicate with regarding your medical decisions.
3. Annual care preferences discussion: It's advisable to discuss your care preferences with your proxy every year. This allows you to revisit and reconfirm your wishes and keep your proxy well-informed.
4. Updating your proxy: If you ever need to change your healthcare proxy, complete a new advance directive form with the updated information and inform your healthcare providers about the change. This ensures that the right person can make medical decisions on your behalf.

Remember that maintaining open and transparent communication with your healthcare proxy is essential. Periodically confirming the proxy's comfort in the role and ensuring that they fully understand your healthcare preferences helps empower them to advocate for you effectively when needed.