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Should I set up a health care power of attorney document for my parent with dementia?

March 30, 2012

Question: My wife and I set up powers of attorney for health care several years ago and have never used them. My mother claims to have one, but we can’t find it. She was only recently diagnosed with Alzheimer’s and doesn’t like talking about a future she isn’t in charge of! Is it worth the hassle of getting a new one done for her?

Congratulations on your good judgment and willingness to plan ahead! Designating someone to make health care decisions on your behalf when you are debilitated—the function of a health care or medical power of attorney (POA)—is a wise move at any age.

I would definitely recommend taking steps to have your mother do a new POA for health care, particularly since she may not be able to create and sign such a document later in her illness. The document can provide you with a powerful tool for managing her health care and making important decisions to better her quality of life.

These forms are widely available and usually do not require a notary. Instead, they need to be witnessed by someone not named in the document.

Here are some examples of situations calling for a power of attorney for health care:

  • Communication with physicians and health providers. Most will refuse to release information without that POA.
  • Decision making in hospital settings. Most hospitals want to see your POA to involve you in decisions about care and treatment, including issues around end of life or resuscitation.
  • Utilizing services. Many home health, hospice or residential care programs will ask for a power of attorney for health care if you are authorizing services on behalf of a family member.
  • Skilled nursing settings. A POA may be needed to arrange short-term rehabilitation in case of a fall or after a hospitalization.
  • Funeral arrangements. Some mortuaries will want to see a health care power of attorney in order for you to make pre-arrangements.

Having traveled the caregiver journey myself for my Mom with Alzheimer’s disease, I have to say that having the POA from her was invaluable. It allowed me to sign on behalf of my mother when needed and get important information about her situation. It also relieved my father of having to make all the decisions when he was not at his best.

It’s important to resolve this issue while your mom is still capable. Why not set aside a morning to redo the document with her? Say something like, “Mom, your good health is the envy of everybody! But accidents happen. Let’s make sure that if for some reason you can’t communicate with Doctor Smith, a person you trust can make decisions for you.”

One trick I heard from a family is that they asked their reluctant mom with early stage Alzheimer’s to be their power of attorney and then asked for hers in exchange. The whole situation seemed more inclusive, and reduced her defensiveness and suspicion. This “swapping” of documents led to success!

Another tip is to practice the art of good timing. If mom declines the first time, keep trying. Eventually she may be in a good space and you can get the documents signed and celebrate with some ice-cream!

Good luck with your efforts.

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