Durable Power of Attorney: A Labor of Love

Posted on Wednesday February 12, 2014 in Hospice Education

undefined It’s a simple fact of life: No one likes talking about death—especially when it means planning for the inevitable future of a beloved family member. Health care professionals avoid mentioning wills and powers of attorney for the same reasons:

It’s difficult to talk about.
It can be emotional.
It’s time-consuming.

But planning ahead—even though it can be painful—can save a lot of time, trouble and heartache when a loved one --or patient -- is incapacitated. Discussing wills and Durable Powers of Attorney (DPOA) is something every medical professional must learn to do.

“You do it because you’re a good physician and you care about your patients,” says Dr. Pam Erdman, Medical Director at Crossroads Hospice in Atlanta, GA. “These discussions take time; it’s not an easy topic to address.”

What is DPOA?

A DPOA, or “labor of love,” as Dr. Erdman calls it, is the place to declare another person as an agent on one’s behalf, even after becoming incapacitated. In layman’s terms this means that a patient can choose someone to make decisions on his behalf. Laws vary by state, and often times you must declare a DPOA for health care, and a separate DPOA for financial reasons.

When should you discuss DPOA?

It’s important to discuss DPOA early, even when there’s no illness. At the very latest, families should discuss this when a terminal diagnosis is received.

“The time to think about it isn’t in an ER,” says Dr. Erdman. “It’s best to do it during a routine visit or well visit . . . when cooler heads prevail.” Dr. Erdman says. An additional benefit of discussing DPOA during a routine visit? Patients and families can chat with their regular doctor instead of an unfamiliar medical professional.

After a DPOA has been established, it can be adjusted as needed. “They are not [written in stone],” says Dr. Erdman. “They can be revised and changed as your thinking evolves or your physical condition changes.”

How should a medical professional talk about DPOA?

To get the DPOA conversation started, a few standard questions should be asked. From there, the conversation will evolve.

Would you want to be resuscitated knowing that the survival rate is 10%?
Would you want to be resuscitated knowing that you might not be the same way?
If you knew you would not be able to eat again, would you want a feeding tube?

Who should hold the DPOA?

Another important question: Who will have the DPOA? Some states allow anyone to be appointed a DPOA, not just a family member, something Dr. Erdman recommends.

“If you’re a family member, it’s a horrible spot to be in to make decisions. It’s sometimes easier to be a person outside the family relationships — and not under the same emotional distress of having someone you love be terminally ill,” she says.

Sometimes in life the most difficult discussions are the ones that are most important to have. If someone cannot speak for themselves a DPOA can ensure that their choices will be ultimately be honored.