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How to Choose the Right Medical Advocate

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Chances are you have a living will. This document (also known as an advance directive) spells out exactly what you wish to have done—or not done—when end-of-life medical decisions must be made. (Note: If you don’t have a living will, the website CaringInfo.org has free downloadable advance directives with instructions for each state.)

But there are many other times when you may be unable or unwilling to make an important medical decision. You may be hospitalized for major surgery, a stroke or some other serious condition, and due to the powerful medications and/or treatments you’re receiving, you can easily become confused—or even delusional. Or you may be home but too weak because of a chronic, debilitating condition to be fully aware of your medical options. In these cases, unless you have a spouse or have legally designated another family member or friend as your advocate, medical personnel can (and usually do) make the decisions.

That’s why it’s so important to choose an advocate while you are still in full control of your faculties. Points to consider when choosing an advocate…

• Look for someone who will doggedly represent you. It should be a person you know well and trust completely. It may be a family member or a close friend. If possible, the person should live near you so that he/she can be there when needed. Be sure to tell that person the key facts about your health, such as chronic conditions, medication allergies, etc. (It’s most helpful to give this information in writing.) Insider tip: Be sure your advocate understands your philosophy about life. For example, would you want to extend your life for a certain period…even if the quality was significantly limited? Do you have religious beliefs, such as not having blood transfusions, that might be counter to what doctors may advise?

• Make sure it’s legal. To avoid any confusion when decisions must be made, it’s best to make your choice of an advocate legally binding. If you are married, under the law, your spouse automatically becomes your legal health-care advocate, and no paperwork is needed. However, if you do not want your husband or wife as your advocate or your spouse is unable to perform the duties, you can create a legal document known as a Durable Power of Attorney (POA) for Health/Medical Care (different states have slightly different names for this form, such as Medical Power of Attorney) to indicate the person you have selected to have that power. Note: Most states do not require this to be drawn up by a lawyer, but you should be very specific about what your preferences are in the document itself and have it notarized if the state requires it. There are websites with free power of attorney forms that are tailored to your state’s laws. I like PowerOfAttorney.com because it has samples of the various types of power of attorney forms you might consider, such as a separate POA that grants someone else control over your finances. POAs for health care go into effect when a doctor says that you are unable to make your own decisions. Insider tip: Power of attorney forms do not supersede a living will. Because living wills apply only to end-of-life care, you should have both. Make sure your advocate has a copy of your living will so that he can present both documents in any medical circumstance where they may be needed.

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Source: Charles B. Inlander, a consumer advocate and health-care consultant based in Fogelsville, Pennsylvania. He was the founding president of the nonprofit People’s Medical Society, a consumer advocacy organization credited with key improvements in the quality of US health care, and author or coauthor of more than 20 consumer-health books. Date: March 1, 2018
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