An Alzheimer’s diagnosis is a life-changing event that can alter the way you think about your future (or that of your loved one). Alzheimer’s progression can often be unpredictable, so it’s important to plan for the care and well-being of a person living with the condition as early as possible. Part of that preparation includes arranging for someone to have medical power of attorney (POA).

Some people might struggle with advance care planning, such as creating a living will or filling out advance directives. Planning for your future ensures that your wishes are fulfilled. It can also make it easier for your loved ones to navigate challenging end-of-life care decisions.

Members of myALZteam have mentioned the importance of these documents. One member wrote, “Do get the paperwork done early — power of attorney, health care power of attorney, living will. Hopefully, you will not need any of them soon, but it will be so much easier if he can sign the paperwork now.”

Another shared, “We signed power of attorney and patient advocate paperwork as well as obtained living wills. It was a relief to get those things in order before he can’t understand anymore.”

Here’s what you should know about designating who will have POA so you can appoint the best person for this important role.

What Is Medical Power of Attorney?

A medical POA, sometimes called a durable power of attorney for health care, is a legal document that gives another person the ability to make medical decisions on your behalf if you’re unable to make them yourself. In the United States, specific laws vary from state to state for setting up a medical POA. The person you choose may be referred to as your:

• Health care agent
• Health care proxy
• Health care surrogate
• Health care representative
• Health care attorney-in-fact
• Patient advocate

A medical POA agent must follow the predetermined guidelines that you specify. However, they can make significant decisions, including whether to keep you on life support or discontinue medical treatment.

Potential Benefits and Risks

Choosing a medical POA agent can reduce the burden on your loved ones when your mental capacity declines or if you are fully incapacitated. Outlining your preferences in advance directives gives you better control over your medical care when you need it most. Health care situations can be complicated, and it’s a good idea for anyone with Alzheimer’s to have a trusted person who can act as their advocate.

Just like planning your financial affairs through wills, making medical care decisions in advance — or at least choosing someone who understands what life decisions you prefer — can prevent others from grappling with difficult choices about your care.

If you don’t choose a medical POA agent, one may be chosen for you. The following people are legally authorized to make decisions about your care (in the order listed) if you’re incapacitated:

• Any guardians or conservators previously appointed by a court
• A legal spouse or domestic partner
• An adult child
• An adult sibling
• A caregiver (who is not your health care provider)
• A close friend or nearby relative

If you don’t want any of the above to have power over your care, it’s important to have paperwork in place to specify that condition. Designating a medical POA agent ensures that your preferred person or people will be in charge.

Of course, there’s always risk involved when you give another person legal authority over your decision-making rights. However, medical POA doesn’t come into play unless you don’t have the mental capacity or ability to communicate. A doctor must verify your inability to make health care decisions before your agent can intervene. You can also set limits on the types of medical decisions your agent can make for you, and they must follow any instructions you’ve provided. If a court believes that your health care agent is not acting in your best interests or in line with your previously designed desires, the right of medical POA can be revoked.

Ideally, you should choose a medical POA agent before your mental health comes into question. Because circumstances may change over time, you have the right to change your agent or revoke their rights as long as you’re still capable of making decisions. For example, if a spouse was given the POA, they may have this right removed if a divorce occurs. Be sure to read through the terms or meet with an elder law attorney or social worker who can help explain the ins and outs of your medical POA document before signing.

Choosing the Right Person

The rules vary by state, but in general, a person must meet a few criteria before they can be given medical POA. For instance, your agent must be over 18 years of age (or legally emancipated). They can’t be your health care provider or your long-term care provider (if you live in an assisted-living facility or nursing home). In addition, they should not be related to your health care or long-term care provider.

Additionally, you’ll want to steer clear of choosing anyone you don’t fully trust or believe can handle the responsibility.

Examples of the people who are typically appointed to be health care agents include:

• A family member
• A close friend
• A member of your religious community
• A trusted neighbor

Be sure to inform the person you choose as your agent so they can be prepared and available if called upon. Have a discussion with this person before you make this decision so that each of you has an understanding of the legal relationship you’ll be entering into. Let your loved ones and your health care professionals know your reasoning for choosing this person and encourage them to support your agent in fulfilling their decision-making responsibilities.

Members of myALZteam have shared stories about issues that arise when family members try to change the designated POA. One member shared that their mother used to live in New York with their brother but later moved in with them in Florida. According to the member, the brother was given POA when the mother was still capable of signing the paperwork. After the mother moved, the brother refused to sign a declination letter to switch over the POA.

Another member suggested dividing up the responsibilities and explained how their family has set things up:

“My wife has a power-of-attorney document that appoints me as her attorney-in-fact, which allows me to make legal and financial decisions for her. Separately, my wife has a health care directive that appoints me as her health care agent. If your mother has both types of agreements, then a possible ‘first step’ might be to have you appointed as your mother’s health care agent since you are with her all of the time. Your brother, as your mother’s attorney-in-fact, could set up that new agreement.”

It’s important to take into account where you’ll be living and which family member is most likely to need the ability to make frequent POA decisions for you.

How Do You Complete the Process?

For most parts of the United States, there’s a simplified form you can use to designate your health care agent. This bare-bones multistate form is valid in every state except Ohio, New Hampshire, Texas, and Wisconsin. Each of these states has its own mandatory disclosure statement.

You should be able to find medical POA forms on your state government’s website. Most states don’t require a notary, but typically two witnesses must be present to certify that you signed the forms. Different states have specific rules on who can serve as a witness, so be sure to read the terms carefully. It’s also highly recommended that you seek legal advice from a reliable attorney before finalizing all documents during this legal planning process.

While selecting a medical POA agent, you may also want to put other legal documents in place that define the type of medical treatment you want, how your bank accounts will be managed, long-term care, estate planning, and who will care for your dependents (if applicable).

Talk With Others Who Understand

On myALZteam, the social network for people with Alzheimer’s disease, you can connect with other people living with this condition. Members come together to ask questions, give advice, and share their stories with others who understand life with Alzheimer’s.

Have you thought about making legal arrangements for yourself or someone you care for with Alzheimer’s? Share your insight or experience in the comments below, or start a conversation by posting on your Activities page.