How to Choose a Healthcare Proxy

Copyright © 2014 AARP. All rights reserved.

One of the most important decisions you can make in your long-term care planning is the choice of healthcare proxy: the person who will make healthcare decisions for you when you are unable to do so yourself.

This person should be someone you trust to put your wishes ahead of his or her own feelings. A calm, careful approach to problem solving is an asset, as is the ability to listen to other points of view and mediate differences of opinion.

The ability to absorb medical information and ask clarifying questions is a valuable skill. Disagreements often stem from poor communication about the person's medical condition, and sometimes doctors are reluctant to give bad news in a clear way. The proxy may have to read between the lines or ask very direct questions.

Location is another factor; although your healthcare proxy does not need to live with you or even in the same town, it is not a good idea to pick someone far away in case decisions have to be made quickly. Another good idea is to name an alternate as a backup.

A family member is usually the first option, but you may want to choose a friend instead. (Your doctor cannot be your healthcare proxy.) If you have siblings or more than one child, think which one best meets these personal characteristics, regardless of birth order, age, or profession.

Make sure your healthcare proxy understands your wishes. Many people chosen as healthcare proxies (or not officially named as such) may ask a doctor, “What would you do if this were your mother?” This is not a good question because it assumes that your mother and the doctor's mother have exactly the same history, beliefs, and wishes.

The doctor's mother may have wanted something very different from what your mother expressed. Many experienced doctors deflect this question by saying, “Tell me a little more about your mother.” That conversation can lead to a better understanding of the options.

Be sure to discuss this responsibility with the person you think is best suited for the job and ask if he or she is willing to take on this responsibility. It should never be a surprise to that person.

Make sure you tell all other family members who will be involved whom you have selected to make medical decisions for you. They should not be surprised, either. Some will be relieved not to have this responsibility; others may resent your choice.

If you are the healthcare proxy, make sure you keep other family members informed about what is happening and what is likely to happen. Many deathbed family conflicts arise because of lack of communication, which leads to lack of trust.

Once you have a signed and witnessed advance care directive, make sure your doctors, healthcare proxy, family members, clergy, and any others you want involved in your care have copies. Keep the original in a safe and easily accessible place should you be hospitalized and your regular doctor is not available. The document does not need to be filed with any agency, and you can write a new one whenever you choose.

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