HCPOAs Frequently Called On to Make Health Care Decisions

Have you considered using advance directives, and especially the health care power of attorney, as a way to invite prospective clients into your office?  Or as a way to communicate to current clients the importance of this non-monetary piece of their estate plan that you create?

If so, you might want to use some of these figures in communicating the importance of the HCPOA to prospects and clients alike.  As it turns out, surrogate decision-makers are quite likely to be called upon to make health care decisions.  Especially for adults over 60.

There is not much information available about how and when surrogate decision-makers are called upon.  Here are some results from two relatively recent studies (2014 and 2010) looking at the likelihood of older patients to need their surrogates to make health care decisions with or for them.

When people who were 65 years and older went to the hospital for at least 2 days:¹ 

• Almost a third (32% overall) needed their surrogate decision-maker to be involved in making health care decisions. (These were hospitalizations for medical (not surgical) conditions.)
• Almost half (47%) needed their surrogate decision-maker involved in a decision if a significant medical decision was required (such as approving a procedure or operation, discharge to another facility, and life-sustaining care).
• Almost a quarter (23%) needed their surrogate to function as their sole decision-maker when a significant medical decision was required.
• Almost three quarters (71%) of patients in the ICU required surrogate decision-making.

When people 60 years and over reached the end of their lives: ²

• More than a quarter (30% overall) needed the surrogate to act (because they lacked decision-making capacity).
• Almost three quarters (70%) needed the agent to act in cases where a decision about treatment was needed.
• An adult child or grandchild served as the surrogate about 65% of the time. (The spouse served 27%.)

Some estate planning attorneys have offered advance directive packages at a reduced fee to bring in prospective clients.  Others have encouraged clients to update their advance directives, including their HCPOA, as a way to stay in contact with existing clients.  I hope you can use some of these figures in this or other ways.

Randi J. Siegel, MBA, is the President of DocuBank® (docubank.com), which ensures that the emergency information and healthcare directives of its 250,000+ enrollees are available 24/7/365 through the largest advance directives registry in the U.S., as well as access to an online safe for storage of digital assets and other vital documents. Working with estate planning professionals since 1997, Randi frequently speaks at national estate planning conferences and has appeared on radio and television as an authority on registries. A member of the Philadelphia Estate Planning Council, the International Society of Advance Care Planning and the Coalition to Transform Advanced Care, Randi is active in health education and public engagement related to advance care planning/advance directives. She serves as Pennsylvania liaison to the National Healthcare Decisions Day initiative and as a board member of the Center for Advocacy for the Rights and Interests of the Elderly. Randi is an ongoing contributor to the Academy blog.

Academy Guest Blogger
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