In North Carolina, a Health Care Power of Attorney (some states call it a health care proxy or advance medical directive) is critical if you want to protect your own future well-being and reduce the likelihood of stress and family conflict over your future health care. 

What Does a Health Care Power of Attorney Do?

A North Carolina Health Care Power of Attorney allows you to name the person (your agent) that you want to make your health care decisions if you are unable to make those decisions yourself. Generally, you would name your first choice to serve as your health care agent and then would also nominate one or more back-ups in case your first choice is unable to serve. The Health Care Power of Attorney then provides specific powers for what health care and medical decisions your agent has authority to make in the event that you become incapacitated.

Why Is it Important to Have a Health Care Power of Attorney?

Do you recognize the name Terri Schiavo?  In 1990 Terri suffered cardiac arrest that resulted in Terri going into a persistent vegetative state due to brain damage from lack of oxygen. Terri was placed on artificial life support, including a feeding tube. Terri's husband and parents then fought their way through the court system for years over who had the legal authority to make Terri's health care decisions and whether or not she would have wanted life-sustaining treatments under the circumstances. The case went through 14 appeals and was not resolved until 15 years later, when in 2005 the case was resolved. Terri's feeding tube was removed on March 18, 2005 and she passed away on March 31, 2005. 

Terri's case was in the national news of years and sparked a public discussion regarding the importance of health care directives and a health care power of attorney that clearly identifies who the health care decision maker is and what decisions that person is authorized to make. In short, if you don’t want to “famous” like Terri, I strongly encourage you to have a properly executed Health Care Power of Attorney that clearly sets out who is authorized to make your medical decisions. 

But Is a Health Care Power of Attorney Enough? Are There Other Health Care Directives That I Need?

Arguably, no.  Anyone I've ever spoken with who has served as a health care agent for a loved one has some sort of story to share about how stressful it was and how uncertain they felt about their loved one's wishes.  Making life or death decisions is not easy, especially when your loved one wants to honor your wishes. 

These days, it's common for a Health Care Agent to serve as your agent for months or years. If you become incapacitated from an accident, stroke, or debilitat

ing long-term illness such as dementia, Alzheimer's disease, or Parkinson's disease, your Health Care Agent may be called upon to serve as your agent for years and make numerous decisions about your living environment, long-term care needs, and end-of-life care decisions.

Serving as Health Care Agent can be an emotionally difficult role. We find that often, the Health Care Agent doesn't truly know what your wishes are. These are uncomfortable topics to think about and discuss. We find that many people have only made generic statements to their family members along the lines of "I don't want to be kept alive by machines" or "Don't put me in a nursing home." Unfortunately, the health care world is not usually so black and white. There is a whole spectrum of health care decisions and caregiving needs that could arise and those vague statements don't really give your Health Care Agent any meaningful guidance to work with.

What Else Should I Do?

Health Care Puzzle

In our office, we supplement the Health Care Power of Attorney with several items. Many of our clients have expressed a desire to make things as 

easy as possible for their family, but when it comes to providing guidance about their health care wishes, they find themselves at a bit of a loss. That's why we've developed several supporting tools to make this easier for

 you and for your future Health Care Agent.

HIPAA Authorization

A separate HIPAA Authorization is recommended to ensure that your family doesn't get the 'silent treatment' due to cumbersome HIPAA medical privacy laws. Doctors, hospitals, and other health care providers are prohibited by law from sharing your information with others--including your spouse or family members--without specific written authorization to do so.

Living Will

Our Living Will addresses multiple potential end-of-life scenarios and allows you to specify under each scenario treatments that would or would not want ranging from treatments that are considered by most to be quite invasive to non-invasive treatments like antibiotics and simple diagnostics.

Letter of Instruction to My Health Care Agent

Our Letter of Instruction to My Health Care Agent provides you with a tool to think through other potential health care scenarios including your thoughts regarding surgery, chemotherapy, alternative or experimental medicine, right to die laws, family visitation, dementia directives, and long-term care wishes.

Personal Care Plan

Our Personal Care Plan tells future potential caregivers about you as a person. All the things that can be easy to take for granted while we're healthy, but can suddenly become important if you can no longer express your wishes. For example, if you were to have aphasia after a stroke, you may be fully cognizant but may have difficulties communicating with your caregivers. The Personal Care Plan addresses things such as what you like to eat and drink, hobbies, what you like to watch on television, what music you enjoy, and similar.

Personal Planning Portfolio

Our Personal Planning Portfolio then assembles this guidance along with instructions for the Health Care Agent explaining their role and their duties and answering frequently asked questions that they may have.

Ideally, a well-rounded estate plan should also address long-term care planning. If you were to need long-term care due to an extended disability or illness, what kind of care would you want? How would you afford to pay for it?

Although it may be uncomfortable to think about some of these issues, we strongly encourage you to share some detailed guidance with your Health Care Agent regarding your health care preferences.  Don't leave your loved ones with the little nagging voice in the back of their head asking, “Am I doing the right thing?” That voice can haunt them for years.

Get Started on Your Planning & Peace of Mind

We can guide you through the steps of creating a comprehensive health care plan and make the process as easy as possible for you and your family. A great place to start if you're looking to learn more is to attend one of our free public seminars or request our report, Estate Planning Pitfalls: The Twelve Most Common Threats To Your Estate & Your Family’s Future. If you'd like to discuss other ways to get started, call us at 919-443-3035 or complete our online contact form.


Jackie Bedard
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Attorney, Author, and Founder of Carolina Family Estate Planning