Who Will Speak For Me: Choosing Your Representative

The representative you name as your medical power of attorney has the power to advocate for your medical wishes and make healthcare decisions for you if you are unable to do so.

Factors to Consider When Choosing a Representative

Your representative, also known as proxy or medical surrogate, can be anyone you trust who is at least 18 years of age (required in most states), your next of kin, another family member, a friend, or someone else. You cannot, however, appoint your primary care physician or any other healthcare practitioner involved in your care unless they are related to you by blood, marriage, or adoption. You can name an alternative representative to step in if your primary representative is unavailable. Once you’ve chosen someone, avoid potential conflict by letting others know your choice.

In Selecting a Representative, Ask Yourself:

• Are they assertive? You want someone who is comfortable speaking with healthcare providers and advocating for you.
• Are they comfortable talking about death? They will need to engage with the subject.
• Do they live nearby? In a crisis, having someone local can be important.
• Will they respect my decisions? They need to understand where you’re coming from and be willing to honor your requests.

The most important thing when selecting a representative is discussing your wishes and making sure the person you choose is familiar with your advance directive and what matters most to you.

Looking Beyond Immediate Family

If you’re finding it hard to identify someone to serve as your representative, remember that they do not have to be a family member.

Some Options to Consider:

• In some cases it may be better to ask a friend whom you trust.
• You can consider asking a neighbor or a member of your faith community.
• When discussing your request, let them know there is no financial liability attached to this role.
• End-of-life doulas are available to assist individuals and families throughout the dying process, from choosing a healthcare proxy to bereavement support. Visit NEDAlliance.org to learn more.
• The LGBTQ+ community may face challenges in end-of-life healthcare settings, including having their preferences ignored or being prevented from accessing their chosen family member. Consider the Hospital Visitation Authorization form on page 39 and an LGBTQ+ specific advance care planning toolkit at CandC.org/LGBTQtoolkit
• Some communities have geriatric case managers who may serve as healthcare representatives for a small fee. Inquire with the Aging Life Care Association at AgingLifeCare.org.
• Attorneys who specialize in elder law may be willing to take on this role. Find a list of local attorneys through the National Academy of Elder Law Attorneys at Naela.org.

NEXT: Putting Plans Into Practice