When your loved one is incapacitated, who will make his or her decisions?

July 15, 2010 by  
Filed under Ask Viki

Who should make the decisions when this person can’t? The answer to this question could be any one of the following:
Person specified on the Advance Directive
Conservator or guardian
Significant other/partner
Adult child of patient
Adult sibling
Healthcare team
Administrator of the nursing home (in some states)

While this is a general list, the answer really depends on where you live, what the patient has specified and if the court has gotten involved. Each state calls the decision maker by a different name: surrogate decision maker, agent, proxy or durable power of attorney for healthcare. The laws that determine who should make the decisions also change state by state. For example, the administrator of a nursing home may be allowed to make the decisions in one state, but can’t in a different state.

Another rule that varies is the law that dictates a specific hierarchy of decision makers. A hierarchy means there is a legal order to who will be allowed to make the decisions for someone who has lost capacity. You may need to ask the social worker, the bioethics committee or the legal department at the hospital to help you figure out the appropriate laws in your state.

Here are some tips to consider when choosing your decision maker.
1. Pick someone who will understand what the doctor is saying.
2. Pick someone who knows you well and has listened to what you want.
3. Pick someone who won’t fall apart in a crisis.
4. Pick someone who will do what you have asked, even if it difficult to do.
5. Pick someone who is close by geographically.
6. Write down whom you don’t want to be involved in the decision making.
7. You can pick two or three people to work together as your decision makers.
8. Your spouse, significant other or partner may not be your best choice, and you may want to choose someone else.
9. In the “Other” section of the form, state whom you do and don’t want to be told your medical information.

Have a kind and respectful day.

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