Medical power of attorney for a friend – and where to get local advice

by Marlene Berlin

What do you do when a friend asks to give you her medical power of attorney? This legal responsibility comes into play when a person becomes incapacitated and cannot make medical decisions for herself. And in many cases, it rests on a spouse, adult child or another member of the family.

But my friend asked me. She had grown distant from her family, and no longer felt they could adequately represent her interests. She wanted a longtime friend. She also knew it was a lot to ask of me, and she said she would understand if I decided it was too much to take on.

My first response was a big gulp. Medical power of attorney is important in end-of-life situations, such as the decision to pull the plug when in a terminal or vegetative state. But it can be much more complicated than that. Having been very involved in my parents’ medical care, I knew very well what this could entail. My responsibilities for my parents had grown from listening to how they handled their illnesses and giving them advice, to researching and advocating over the phone or in person for appropriate care when they were too emotionally fragile and sick to do it for themselves. Then there was communicating and coordinating among my siblings.

There is a level of intimacy and sharing among family that is not the same as with most friends. This allows you a certain amount of intrusiveness into health matters and therefore, a sense of when it’s appropriate and necessary to step into help. I did not want to be intrusive but I would need to be kept abreast of changes in her health and medical needs, given this new responsibility. So we had to figure out how much she should share so that I could be an effective advocate if and when the time came.

Also, there was the added complication that she was planning to retire to Florida. She wanted to keep her doctors in DC and assumed that if anything were to happen in Florida, she would be able to come back to DC to take care of it. I knew from caring for my husband’s parents in Florida that there could be emergencies that necessitated immediate attention. We would need a plan for such a situation.

I told her that I needed time to mull this over. The more I thought about this responsibility, the more I realized we needed to sit down with a third party who was familiar with medical power of attorney and the challenges of aging. I told my friend that we should engage someone from Iona Senior Services to help us hash out these issues.

She agreed and we made an appointment with Deb Rubinstein. Not only is Rubinstein the director of consultation, care management, and counseling at Iona (4125 Albemarle Street), is a lawyer and a social worker. Her adroit questions revealed a support network that my friend already had in place in DC – her doctor, her lawyer and his partner. Although I would make the decisions, she wanted me to collaborate with them. Learning this was a big relief. Rubinstein recommended setting up a meeting to introduce us all to each other.

Rubinstein also quickly dispelled the notion that my friend would be able to make it back to DC for treatment in all situations. She suggested asking her physician to help her find another doctor in Florida. Rubinstein also suggested lining up a care management service that my friend could call on in case of an emergency. This would provide me with a contact in Florida with whom I could work if she became seriously ill.

My friend agreed to follow up on these suggestions. I left the meeting feeling that I could handle the situation with this plan. I would be working with others whom she trusted to make difficult decisions, and she would set up a support network in Florida that I could plug into. We still needed to work out how she’d keep me up-to-date on her medical situation, but that was doable. I told her to get her lawyer to draft the papers.

Tips on choosing someone to make your healthcare decisions, should you be unable to do so yourself, from the American Bar Association:

Choose someone who will talk with you now about your wishes, who will understand what you want and your priorities about health care, and who will do as you ask faithfully when the time comes.

Choose someone who lives near you or could travel to be with you, if needed.

Choose someone you trust with your life.

Choose someone who can handle conflicting opinions from family members, friends, and medical personnel.

Choose someone who can be a strong advocate for you if a doctor or institution is unresponsive.