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Signing a "designation of Health Care Surrogate" form...

Moms View Message Board: General Discussion: Archive October 2006: Signing a "designation of Health Care Surrogate" form...
By Dana on Wednesday, October 18, 2006 - 12:52 pm:

This is a general form I found in my daughters insurance handbook and thought it would be good for me to fill out for myself. It gives power of attorney for health care decisions. It gives pretty standard info and fill in the blanks. Then there is a spot for "additional instructions" I know there should be something I want to put here, but it is difficult to think in those terms. What are some of the key points I want to give directions for. I know I don't want to be left on tubes for excessive amount of time (but then how is that determined?). What about family. Does anything get mentioned here? It is not a will of testament. Thanks.

By Ginny~moderator on Wednesday, October 18, 2006 - 01:31 pm:

Dana, check out the AARP website and see if they have health care power of attorney forms for your state. Also, check with your local hospital and see if they have forms. Laws vary from state to state. One thing I know (from experience) is that (1) it is important to name a surrogate - someone your doctors must talk to and keep informed, someone who can see your records, and, most importantly, someone who is authorized to make decisions on your behalf if you are unable to make decisions (coma, etc.); and (2) you must talk to the person(s) you want to name as surrogate (and alternative surrogate - also a good idea) and make sure you and they are on the same page as for what you would or would not want.

Finally, this document should be notarized - I would make several copies without your signature, take it to a notary, sign it, and have at least 4 notarized copies - one for you, one for the surrogate or surrogates, one for your primary care doctor's files, and one just in case. And, in some states, it is required that the named surrogate also sign to indicate his/her willingness to take on that responsibility.

I'll check my files, because I know I have one (and should update it), and I can email it to you if you email to me at klip vm at rcn dot com. But, remember, mine complies with Pennsylvania law.

Oh, and your state's website might have model/standard health surrogacy or health care power of attorney forms. Many states do have forms that comply with that state's laws, and you can add in some details (but not many).

Yes, it is a very good idea. I know it made my mom's life a whole lot easier after my dad had done this, as he was in and out of hospitals and in and out of mental competency. But, it is not a be-all and end-all to problems. Even with having the power of attorney and surrogacy designation, there were issues of medical care that came up with my dad that weren't "covered" in the documents, and mom and the doctor and I had to sit down and figure out what was best. That's why it is so important for you and your surrogate to talk to be sure you are very much "on the same page", so that s/he has the general idea and/or principles as a guide when uncovered issues arise.


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