Search Articles

Find Attorneys

Health Care Proxy: Who Makes Medical Decisions If You Can't?

  • January 23rd, 2024

A senior man holding his wife's hand at her hospital bedside.Being able to make health care decisions for ourselves is so important to us. However, what happens if you become incapable of making choices or unable to voice your opinion? If you don’t have a health care proxy or guardian in place, state law chooses who can make those decisions.

What Exactly Is a Health Care Proxy?

As part of your estate plan, you can appoint an individual as your health care proxy. (Note that you may hear attorneys refer to this role with different terms, depending on your state. Some call it a medical power of attorney. Others use the terms health care representative or health care power of attorney.)

The person you name to take this role on should be someone you trust without reservation. You will be authorizing them to make medical decisions on your behalf if you become unable to do so. Ideally, your agent will be aware of your values and wishes regarding life-saving treatments or end-of-life care. In addition, you want to select someone who will honor those wishes, even when they may not personally agree with them.

Local Elder Law Attorneys in Your City

Elder Law Attorney

Firm Name
City, State

Elder Law Attorney

Firm Name
City, State

Elder Law Attorney

Firm Name
City, State

In some states, you may be able to name an alternate health care proxy.

What Happens Without a Medical Power of Attorney?

In an emergency, health care providers can take measures to keep us alive. However, once the emergency has passed, they will look for someone to make the next most crucial medical decisions.

If you are seriously ill or injured, you may be unable to express your decisions (either temporarily or permanently). In that case, your doctors will consult the agent you've so carefully appointed. But if you have no one like this in place, then most state laws dictate who has the right to act on your behalf.

The list of surrogates who can make medical decisions for you usually goes in order of priority. For example, it may start with your spouse and adult children. Parents, siblings, grandchildren, and close friends may also be surrogates.

Yet it's quite possible these are not the people you want making decisions for you. Plus, not having your wishes spelled out can cause dissension among your family and confusion for medical professionals.

The Need for Guardianship

A few states do not have laws dictating who can act in a person’s place if they become unable to express their wishes. In those states, your family may have no choice but to go to court to get a guardian appointed. Even in states with surrogate laws, family members on the surrogate list may disagree over your medical treatment. They could even end up in court anyway, asking the court to appoint a guardian for you.

Guardianship is a type of legal relationship. A competent adult, the guardian, attains the power to make decisions for another individual, the ward. The ward is someone who can no longer take care of their own affairs, often because of serious illness or injury.

Consult With an Estate Planning Attorney

The guardian can obtain the authority to make legal, financial, and health care decisions for the ward. The process to appoint a guardian, however, is expensive, time-consuming, and quite restrictive. That's why guardianship almost always serves as a last resort.

To avoid the state choosing who acts for you, have a health care proxy (or health care power of attorney) in place. Work with a qualified attorney to help you choose the right individual and draw up the necessary documents.

By executing a health care proxy, you are authorizing your agent to carry out your wishes. Doctors and other medical professionals will defer to the person named in the document to act on your behalf.

Find an estate planning attorney near you today. Keep in mind that a local attorney will be familiar with the laws governing your state. If you have a health care proxy in place, consider reviewing and updating it as part of your estate plan every few years. After all, your health can change, as can your willingness to endure certain medical treatments over the course of your lifetime.

To get a better understanding of these types of legal arrangements, check out the following informative articles:


Created date: 11/03/2021
Medicaid 101
What Medicaid Covers

In addition to nursing home care, Medicaid may cover home care and some care in an assisted living facility. Coverage in your state may depend on waivers of federal rules.

READ MORE
How to Qualify for Medicaid

To be eligible for Medicaid long-term care, recipients must have limited incomes and no more than $2,000 (in most states). Special rules apply for the home and other assets.

READ MORE
Medicaid’s Protections for Spouses

Spouses of Medicaid nursing home residents have special protections to keep them from becoming impoverished.

READ MORE
What Medicaid Covers

In addition to nursing home care, Medicaid may cover home care and some care in an assisted living facility. Coverage in your state may depend on waivers of federal rules.

READ MORE
How to Qualify for Medicaid

To be eligible for Medicaid long-term care, recipients must have limited incomes and no more than $2,000 (in most states). Special rules apply for the home and other assets.

READ MORE
Medicaid’s Protections for Spouses

Spouses of Medicaid nursing home residents have special protections to keep them from becoming impoverished.

READ MORE
Medicaid Planning Strategies

Careful planning for potentially devastating long-term care costs can help protect your estate, whether for your spouse or for your children.

READ MORE
Estate Recovery: Can Medicaid Take My House After I’m Gone?

If steps aren't taken to protect the Medicaid recipient's house from the state’s attempts to recover benefits paid, the house may need to be sold.

READ MORE
Help Qualifying and Paying for Medicaid, Or Avoiding Nursing Home Care

There are ways to handle excess income or assets and still qualify for Medicaid long-term care, and programs that deliver care at home rather than in a nursing home.

READ MORE
Are Adult Children Responsible for Their Parents’ Care?

Most states have laws on the books making adult children responsible if their parents can't afford to take care of themselves.

READ MORE
Applying for Medicaid

Applying for Medicaid is a highly technical and complex process, and bad advice can actually make it more difficult to qualify for benefits.

READ MORE
Alternatives to Medicaid

Medicare's coverage of nursing home care is quite limited. For those who can afford it and who can qualify for coverage, long-term care insurance is the best alternative to Medicaid.

READ MORE
ElderLaw 101
Estate Planning

Distinguish the key concepts in estate planning, including the will, the trust, probate, the power of attorney, and how to avoid estate taxes.

READ MORE
Grandchildren

Learn about grandparents’ visitation rights and how to avoid tax and public benefit issues when making gifts to grandchildren.

READ MORE
Guardianship/Conservatorship

Understand when and how a court appoints a guardian or conservator for an adult who becomes incapacitated, and how to avoid guardianship.

READ MORE
Health Care Decisions

We need to plan for the possibility that we will become unable to make our own medical decisions. This may take the form of a health care proxy, a medical directive, a living will, or a combination of these.

READ MORE
Estate Planning

Distinguish the key concepts in estate planning, including the will, the trust, probate, the power of attorney, and how to avoid estate taxes.

READ MORE
Grandchildren

Learn about grandparents’ visitation rights and how to avoid tax and public benefit issues when making gifts to grandchildren.

READ MORE
Guardianship/Conservatorship

Understand when and how a court appoints a guardian or conservator for an adult who becomes incapacitated, and how to avoid guardianship.

READ MORE
Health Care Decisions

We need to plan for the possibility that we will become unable to make our own medical decisions. This may take the form of a health care proxy, a medical directive, a living will, or a combination of these.

READ MORE
Long-Term Care Insurance

Understand the ins and outs of insurance to cover the high cost of nursing home care, including when to buy it, how much to buy, and which spouse should get the coverage.

READ MORE
Medicare

Learn who qualifies for Medicare, what the program covers, all about Medicare Advantage, and how to supplement Medicare’s coverage.

READ MORE
Retirement Planning

We explain the five phases of retirement planning, the difference between a 401(k) and an IRA, types of investments, asset diversification, the required minimum distribution rules, and more.

READ MORE
Senior Living

Find out how to choose a nursing home or assisted living facility, when to fight a discharge, the rights of nursing home residents, all about reverse mortgages, and more.

READ MORE
Social Security

Get a solid grounding in Social Security, including who is eligible, how to apply, spousal benefits, the taxation of benefits, how work affects payments, and SSDI and SSI.

READ MORE
Special Needs Planning

Learn how a special needs trust can preserve assets for a person with disabilities without jeopardizing Medicaid and SSI, and how to plan for when caregivers are gone.

READ MORE
Veterans Benefits

Explore benefits for older veterans, including the VA’s disability pension benefit, aid and attendance, and long-term care coverage for veterans and surviving spouses.

READ MORE