Medical power of attorney: how it works and how to set one up

The short answer: a medical power of attorney is a legal document that names the person who will make health care decisions for you if you cannot make them yourself.

• That person may be called an agent, proxy, surrogate or representative
• Get your state's form and talk with your agent first
• Sign with the required witnesses or notary
• Review it every year and pair it with a living will
• Next step: Plan it with the Caregiver Organizer ($6.99).

A medical power of attorney is a legal document that names the person who will make health care decisions for you if you cannot make them yourself. Mayo Clinic's guide to advance directives explains that this person may be called a health care agent, proxy, surrogate or representative depending on your state. MedlinePlus adds that a health care power of attorney does not give anyone control over your legal or financial decisions. Here is how it works, how to choose your agent, how to sign the form and how to keep it ready for the day it is needed.

What is power of attorney?

Power of attorney is a legal grant of authority from you (the principal) to someone else (the agent) to act on your behalf. There are a few kinds, and people often need more than one.

The word "durable" means the document keeps working if you lose capacity, which is the whole point for health care. A medical power of attorney is durable by design.

How to choose your health care agent

Mayo Clinic suggests choosing someone who meets your state's requirements, is not your doctor or part of your care team, is willing to talk about end-of-life care, will follow your wishes and can speak up if there is disagreement. In practice, ask yourself:

• Will this person be reachable quickly, and live close enough to get to a hospital?
• Can they put my wishes ahead of their own feelings?
• Will they stand firm if other relatives push back?
• Do they understand my health and my values?

The agent can be a spouse, an adult child, a sibling, a friend or someone from your faith community. Name a first and second alternate in case your agent cannot serve.

How to set up a medical power of attorney

1. Get your state's form. Hospitals, state health departments and aging agencies offer free forms. Many states combine the medical power of attorney and living will.
2. Talk with your agent first. Ask them directly if they are willing, and explain what you would want.
3. Fill in the agent and alternates with full names and phone numbers.
4. Add instructions or limits. You can say what the agent may not decide, or when the authority begins.
5. Sign with the required witnesses or notary. Rules differ by state, and witnesses usually cannot be your agent.
6. Distribute copies to your agent, alternates and doctors, and ask that it be added to your medical record.
7. Review it after marriage, divorce, a move to another state or a falling-out with your agent.

Medical power of attorney form: where to get one and what is on it

The National Institute on Aging's guide to advance directives says free state forms are available, and suggests contacting your State Attorney General's Office or your local Area Agency on Aging if you need help. Hospitals, state health departments and legal aid offices often have them too. The American Bar Association's Commission on Law and Aging and your state bar association are also good places to look for plain-language guidance. Most state forms have the same parts:

If you spend a lot of time in more than one state, NIA suggests preparing a form for each state and keeping a copy in each place.

How to get medical power of attorney for a parent

You cannot get medical power of attorney for someone else on your own. Your parent has to sign it while they can still understand what they are signing. What you can do is help:

1. Start the conversation early, ideally while your parent is well. Ask who they would want and what matters to them.
2. Get their state's form and read it together.
3. Help with the signing: book the notary or arrange witnesses who meet the state's rules.
4. Make copies for the doctors, the hospital record and each alternate.
5. Keep it with the rest of their care paperwork so you can hand it over at admission.

NIA notes a lawyer can help but is not required. If your parent can no longer make decisions and never signed one, state law decides who speaks for them, which is typically a spouse, then parents if available, then adult children. When family members disagree or nobody qualifies, a court may need to appoint a guardian.

What your agent can and cannot do

Your agent can typically talk with your doctors, see your medical records, agree to or refuse tests and treatment, choose a hospital, nursing home or hospice, and decide about life-sustaining treatment. They must follow your known wishes, and if those are unclear, act in your best interest.

Your agent cannot use a medical power of attorney to pay your bills, sell your home or manage your bank accounts. That takes a separate durable financial power of attorney. Authority also ends at death, when the executor named in your will takes over the estate.

Common situations where it matters

A medical power of attorney is not only for end-of-life care. It is used whenever you cannot decide for yourself, even briefly:

• Surgery and anesthesia: if a complication comes up while you are under anesthesia, your agent can speak for you.
• A car accident or stroke: emergency teams act first, but the hospital will look for someone with authority for later decisions.
• Dementia: as memory declines, the agent gradually takes over medical choices you can no longer weigh.
• A college student away from home: once a child turns 18, parents no longer have automatic authority, so many families have young adults sign one before they leave.
• Unmarried couples: without a document, a partner may have no say if relatives disagree.

Medical power of attorney compared with other forms

NIA notes that an advance directive is legally recognized but not legally binding, which is one more reason the person you choose matters so much. Your agent is the one who speaks up for what you wrote.

For money and property, a durable financial power of attorney is a separate document. Our power of attorney form guide covers the types and how to sign one.

Review it every year

NIA recommends reviewing your advance directives at least once a year and after big changes, such as a new diagnosis, a move to another state, retirement or a divorce. Give the updated version to your proxy, your doctors and your lawyer if you have one, and ask everyone to replace the old copy. If your state has an advance directive registry and you use it, make sure the latest version is on record.

Mistakes to avoid

• Not telling your agent. Being named by surprise in a hospital hallway is hard on everyone. Talk first.
• Naming two co-agents who disagree. If you name two people to act together, decisions can stall. Most forms let you name one agent and one or more alternates instead.
• Leaving the form in a drawer. If the hospital never sees it, it cannot be used. Ask your doctor to scan it into your chart.
• Forgetting privacy permissions. Many people also sign a separate authorization letting doctors share medical information with named family members while they are still able to decide.
• Never reviewing it. Update it after a divorce, if your agent moves far away or if your relationship changes.

Pair it with a living will

A medical power of attorney names who decides. A living will says what you would decide. Together they give your agent both the authority and the instructions. MedlinePlus suggests giving copies to family, providers and your agent and keeping one with you if you go into the hospital.

Being someone's agent: keep the details in one place

If a parent or partner has named you, the hard part is not the document. It is the phone calls, the medication changes and the forms. The Caregiver Organizer ($6.99, printable PDF) keeps a care recipient profile, Care Team Contacts, Medication List, Appointment Log, Daily Care Log, Insurance & documents, a Family Care Schedule, Questions for the Doctor and a Care Expense Log together. Slip a copy of the signed power of attorney into the same binder so it is in your hand at admission.

For your own planning, the If Something Happens to Me Binder ($11.99) records where your signed advance directives are kept, who your agent is and your medical wishes, along with bank accounts, insurance and digital accounts for the people handling your affairs. See also how to make a will, our caregiver daily log template and the medication log for tracking prescriptions.