A POA-HC advance directive names one or more people you trust the most to be your health care agent. They are called upon to make decisions for you if you become incapacitated, according to the decision of a doctor or psychiatrist.

Once you are able to make decisions again, your health care agent is not consulted on a decision.

A power of attorney for finance is the person you name in your last will and testament, the document that describes how your property should be handled. They are assigned duties in your will to make decisions about your finances, property and assets. Your power of attorney for finance is not typically able to make any decisions about your health care.

Purpose

A POA-HC is primarily for naming the people you want to make health care decisions for you. It may also include directions on the specific decisions you want those health care agents to make.

The main purpose of a living will is to give instructions on which life support treatments you would or would not want in an end-of-life crisis. Such treatments may include CPR (“do not resuscitate”/DNR), tube feeding, intubation and ventilation (“do not intubate”/DNI), major surgery, antibiotics or dialysis.

If your health care agents are not available for any reason, your health care team can also use your living will for direction.

Types of medical decisions

A POA-HC gives your health care agents the authority to make all sorts of medical decisions for you, such as choosing whether you should be admitted to a particular kind of health care facility, applying for different kinds of insurance to cover your care or taking legal action on your behalf.

A living will, on the other hand, clearly defines the medical care and treatment you do or do not want to receive in an end-of-life crisis. It’s not used if you’re anticipated to recover.

Refusing or stopping treatment

Under a POA-HC, your health care agent has the power to refuse or stop life-sustaining treatment for you if two doctors determine that life support would only extend the moment of your death and not help you recover.

A living will clearly outlines the medical situations where your doctor can be directed to stop or not use life support treatments you wouldn’t want. These situations include:

• being close to death
• because of old age and frailty or an end-stage terminal condition where treatments are no longer available
• being in a coma and/or having brain damage so that you would never know who you are or who you are with

Yes. In fact, it’s best to have both. They can be either in one document or in separate documents, although there are advantages to having them both in one. That’s why we recommend the Five Wishes booklet, because you can complete both advance directives together along with other instructions for your comfort and how you wish to be treated.

There are certain factors you should consider in making the decision to have either or both documents:

• The grant of powers in a POA-HC may be very broad and will continue even if you become incompetent. Therefore, take great care both in choosing people to be your health care agents and in spelling out the authority, decisions and guidelines for them to follow.
• While the instructions in a living will are more specific regarding life support treatments, great care should still be taken in writing your instructions on what you would want or not want in certain conditions, and what quality of life means to you. These guidelines help both your health care agents and your health care team in making the best decisions based on your wishes, values and goals of care.