Being diagnosed with multiple sclerosis (MS) is a life-changing event that can alter the way you think about your future. Dealing with MS symptoms can put life into perspective and bring up issues that you may not have thought about, including how you want to be cared for if you have significant cognitive impairment or a drastic worsening of your medical condition.
Several members of MyMSTeam have struggled with advance care planning, such as creating a will or filling out advance directives. But planning for the future ensures that your wishes are fulfilled and gives your loved ones guidance in the face of medical emergencies or challenges.
One member commented, “I spent about two hours typing up a power of attorney this afternoon and it took so much out of me.”
Another member wrote, “I was wondering how many people here have an advance directive? If you have one, did you do it yourself or get a lawyer for it?”
In response, a third member shared, “I’m still getting used to the thought of it. Still very scary to me.”
The process can bring up difficult emotions, but learning about the purpose of a medical power of attorney (POA) will help you appoint the best person for this important function, even if you don’t end up needing their help.
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, laws vary by state for setting up a medical POA. The person you choose may be referred to as your:
A medical POA agent must follow any predetermined guidelines that you specify. However, they can make significant life decisions, including whether to keep you on life support or discontinue medical treatment.
For most parts of the country, there’s a simplified form you can use to designate your health care agent. This multistate form is valid in every state except Ohio, New Hampshire, Texas, and Wisconsin. Each of those four states has its own mandatory disclosure statement.
You should be able to find medical POA forms on your state government’s website. Most state laws 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 or seek legal counsel to help you.
While selecting a medical POA agent, you may also want to put other legal documents in place for life insurance, financial planning, estate planning, and who will care for your children (if applicable). Ask your MS specialist for a referral to a social worker or lawyer who can help you with the process while you’re still in a sound state of mind. Taking these steps isn’t just important for people with MS but also for any adult who wants to ensure a say in their future quality of life and MS care.
You may think that a medical POA takes away your rights, but outlining your preferences with advance directives gives you better control over your medical care. Choosing a trusted person to act as your advocate will help your care team navigate unforeseen circumstances.
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 health care (in the order listed) if you’re incapacitated:
If you don’t want any of the above to have power over your care, you can put together a list and legal documents to outline your preferences. Designating a medical POA agent ensures that your preferred person or people will be in charge.
There’s always some risk involved when you give another person legal authority over your rights. However, medical POA doesn’t come into play unless you no longer 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.
The rules may vary by state, but in general, a person must meet a few criteria before they can be granted 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 (for those living in a nursing home or an assisted living facility). In addition, they should not be related to your health care or long-term care provider.
Additionally, steer clear of choosing anyone you don’t fully trust or can’t handle the responsibility.
Examples of people who are typically appointed to be health care agents include:
There’s a lot to consider before signing a medical POA document, including whether you feel the other person is up to the task. Just because someone cares for you doesn’t mean they’re the best choice to act as your representative. Be sure to inform the person you choose as your agent so they can be prepared and available if called upon. It’s also a good idea to let your loved ones know your reasoning for choosing this person and encourage them to support your agent in fulfilling their decision-making responsibilities.
One member of MyMSTeam touched on this important point: “I come from a long line of dementia on my mother’s side. All of us must make sure that we have a plan in place, and EVERYONE KNOWS IT!” they wrote. “I have seen it happen time and time again where a plan is in place and, if nobody knows about it, what good is that? Everyone needs to be on the same page, know what is expected, and what the plan is. Make it easy on them.”
Ideally, you should choose a medical POA agent before your mental health comes into question, as did one member who shared: “I will even venture out into the snowy town with my husband for an appointment with our lawyer about our wills and power of attorney. One of my sons is a physician, and I am giving him power of attorney for a medical directive. Hopefully, that is many many years away, but I like having things as clear as possible now.”
Because circumstances may change over time, you have the right to switch your agent or revoke their rights as long as you’re still capable of making your own health care decisions. 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 a lawyer or social worker who can help explain the ins and outs of your medical POA document before signing.
MyMSTeam is the social network for people with multiple sclerosis. On MyMSTeam, more than 179,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.
Have you designated a medical POA or done any other types of future health care planning? How did you choose the right person, and what was the process like for you? Share your insight in the comments below, or start a conversation by posting on MyMSTeam.