Healthcare Surrogates

Healthcare Surrogates

Turning 18? Graduating high school? Make sure your medical affairs are in order with a healthcare power of attorney.

Like every mom, I want my children to be safe and healthy. But as I packed up my oldest to attend college more than 2,000 miles away this past fall, I realized I was losing control of just that.

I wanted to protect her, to be there if she needed me. If she faced an emergency, I worried I wouldn’t get a call or have the authority to make health decisions on her behalf.

“You would think that would happen by default, but we don’t know that for sure,” says Harry E. Bartosiak of Bartosiak Law in Schaumburg. “A power of attorney document can help avoid doubt, and give certainty and comfort that healthcare decisions are made in the best interest of the young adult.”

When teens turn 18, they’re legally adults — including when it comes to medical decisions. They no longer need their parents’ or guardians’ permission regarding their healthcare choices. This also means that in the event of a medical emergency while the student is away at college, parents may not be contacted or able to find out their child’s condition. Parents also won’t have access to the child’s medical records.

The Health Insurance Portability and Accountability Act of 1996, better known as HIPAA, provides this protection. The 1996 federal law created these national standards to protect sensitive patient health information from being disclosed without the patient’s consent or knowledge.

However, if a young adult is incapacitated and unable to make medical decisions, this privacy protection could be traumatizing for the young adult and for the parents who no longer have any control. It could also leave the student without someone to act on their behalf if they become incapacitated.

“I would encourage all adults aged 18 and older to formally designate who they elect to make healthcare decisions on their behalf should they become ill, incapacitated, or otherwise unable to communicate their own wishes,” says Tom Oryszczak, DO, executive vice president and chief medical officer of Northwest Community Healthcare, part of NorthShore University HealthSystem.

That’s where power of attorney comes into play. With a general POA, you choose another adult to make important decisions for you if you can no longer make those decisions for yourself. A medical power of attorney gives that right to someone specifically regarding healthcare decisions. The document can include specifics about medications you would or wouldn’t want, blood transfusions, organ donation, and more.

“The idea is that the persons you designate know you better than anyone else, and are best able to step into your shoes as a surrogate and make the decisions they know you would in these difficult situations,” Oryszczak says.

Yet, with the mountains of preparation that go into getting ready for that first year of college, not all young adults think to arrange this protection.

Establishing a power of attorney for healthcare

As 18-year-olds pack their bags and head off for college, parents or guardians may want to encourage them to establish a medical power of attorney to ensure they can stay abreast of their teen’s healthcare needs. However, the teens don’t have to select their parents as their healthcare surrogate — especially if they don’t have a safe or trusting relationship. Any trusted adult can serve as power of attorney.

“If you have the POA already in place, the university healthcare system probably has the ability to put it in an electronic medical record,” Bartosiak says. “Then, you dramatically increase the chances of having smoother communication with the healthcare provider.”

Without the document, physicians will legally make medical decisions for the student, and they may not be aware of specific wants and needs, based on the person’s personal or cultural preferences.

“By designating a healthcare surrogate, you are removing any ambiguity about who that decision maker should be. This can remove a lot of the stress for both your loved ones and your healthcare providers in these scenarios,” Oryszczak says.

Bartosiak says the primary healthcare agent (the person designated to make decisions), the student, as well as the university health office should keep a copy of the signed POA.

And Bartosiak says he’s now setting up a POA with his own children, after his clients alerted him to the importance of them and he did further research on his own.

On the POA, young adults must name a principal healthcare agent to make healthcare, mental health, or medication decisions on their behalf. The young adult, as well as a witness over the age of 18 who is not a family member, must sign the document. It does not need to be notarized or prepared by a lawyer.

In addition, a section of the form acts as a living will or advance directive for a physician in case the young adult is in an irreversible coma with no hope of recovery, Bartosiak says.

“This is an underappreciated opportunity for a student to have their personal affairs in order and gives comfort to parents while they’re away,” Bartosiak says.

Our family — including our daughter — feel grateful to have the protection that a POA for healthcare brings. This year, we’ll ask our son to sign a power of attorney as well before he heads off to college — my way of trying to ensure my children will be safe and healthy, and their way of doing the same.

Find the Illinois POA here. It is typically recognized across states.