Medical Power of Attorney: What Family Caregivers Don’t Know

Medical power of attorney and what family caregivers don’t know about the responsibility is a broad subject. The responsibility and accountability of being appointed medical power of attorney are significant. Family caregivers accept the responsibility of medical power of attorney with little or no knowledge of what happens when a loved one needs care or how to create a plan to manage care.

power of attorney what family caregivers don't knowManaging the Care of Elderly Parents

Adult children are most often appointed as medical power of attorney to manage the care of an elderly parent.  What adult children fail to understand is that the responsibility of managing care involves negotiation—a give and take relationship—with an elderly parent.

The role of a medical power of attorney is to support the “principal” or the elderly parent who executed the document. The adult child is considered the “agent.” Most elderly parents have the goal of remaining independent and living in their own homes for as long as possible.

Adult children may have a different desire or opinion of the situation. Being appointed medical power of attorney does not give adult children the legal right to take over making medical and lifestyle decisions for an elderly parent. Being appointed as medical power of attorney is kind of like serving in the role of an assistant or a counselor.

The medical power of attorney’s role is to know the health conditions and the desires of the elderly parent and to be able to communicate this information to others if the elderly parent is unable to communicate on his or her own. This knowledge requires time devoted to understanding health conditions, medications prescribed and wishes for extensive care.

Creating a Power of Attorney Care Plan

This process of learning about health conditions, medical background, and care wishes of an elderly parent can be called creating a power of attorney care plan. A care plan is a written or typed document with historical information and information about personal preferences.

The goal of having this information in writing, in addition to having estate documents drafted that include a living will, is that the information can be confirmed by the elderly parent as accurate. When emergency care needs arise, families can become emotional and disagree about what an elderly parent would have wanted for care.

Written documents avoid confusion and provide a plan for the medical power of attorney to follow in spite of disagreement by brothers and sisters or other family members. Written documents eliminate guesswork and assumptions.

Medical Decision Making

An elderly parent will, at some point, needs support evaluating information and making medical decisions. It is the role of the medical power of attorney provide support in these situations.

Support in making medical decisions may include:

  • obtaining medical or treatment recommendations from a healthcare provider
  • reviewing information with an elderly parent
  • developing a list of questions for the provider
  • making a pro and a con list
  • discussing the short- and long-term prognosis
  • asking an elderly parent about his or her desires for “fixing a problem, getting better, etc.”
  • reviewing treatment costs and other expenses that might be incurred as a result of treatment
  • looking at alternate options if the medical treatment does not result as planned, and
  • discussing the information with an elderly parent to arrive at a decision

Making medical decisions can be viewed as a process or a journey. Because the health of elderly parents is changeable, adjustments or revised plans may need to be made to support changes in the frequency or the type of medical care received.

Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)

Depending on the health situation of an elderly parent, daily decisions about various types of assistance may be required. Elderly parents struggle over time with completing activities of daily living. ADL is the abbreviation for activities of daily living that include: bathing, managing continence, eating, dressing, toileting, mobility, and transfers. This type of assistance is needed as the health and physical abilities of an elderly parent decline.

Other tasks like grocery shopping, meal preparation, arranging and attending medical appointments, picking up prescriptions are less “hands-on” and more social or activity focused projects. Still, someone, if not the power of attorney or the healthy spouse, is needed to assist with these types of activities.

The Costs of Caring for Elderly Parents

The costs of caring for elderly parents include personal costs related to the time of the caregiver or power of attorney and hard costs for which checks are written. As daily needs advance, consideration must be given to who will assist. If not the healthy spouse, the medical power of attorney, or another family member, the cost of paid assistance must be considered.

The Caring Generation® podcast, called The Costs of Caring for Elderly Parents, offers a guide for the costs of a variety of types of care including community care. Discussed during the program is the benefit of Aid and Attendance for wartime veterans including how to know if a loved one qualifies.

Adult children who are medical power of attorney must discuss the costs of care with elderly parents and with the financial power of attorney if this is a different individual. Part of creating a care plan is creating a financial plan that supports the care plan.

Elderly Parents Want to Stay at Home

Most elderly parents want to stay at home. The support of a healthy spouse and adult children are the main components that make the desire to stay at home a reality. In situations where family support is not sufficient due to care needs and the time involved, outside care agencies may be hired.

Families are often shocked at the hourly rates charged that could average between $20 and over $30 an hour depending on where an elderly parent lives. Calculating the costs of caring for elderly parents into a care plan is important for long-term care planning.

Retirement savings and income will go so far. The power of attorney must ask the practical question of what happens when elderly parents spend all of their savings and need care that exceeds the cost of monthly income.

At this point, options, if a parent was a wartime veteran who will qualify, is the Aid and Attendance program or the Medicaid program. Both of these programs have financial and physical qualifications and can have long lead times for approval.

Waiting Can Be Hazardous to the Health of Elderly Parents

Waiting to make a care plan and a financial plan can be hazardous to the health of an elderly parent and to the caregiver who becomes filled with worry. Another responsibility of a medical power of attorney is to ensure an elderly parent has care when needed. This includes when an elderly parent is in relatively good health and at the time of a change in circumstances when a health emergency occurs.

The idea of no surprises is best in care situations. Having a Plan A and a Plan B helps avoid responding in crisis mode to an emergency situation. Making decisions in haste often results in making mistakes that are regretted later.

Avoiding Unexpected Surprises

The idea of having early and frequent conversations about health status, all aspects of medical and daily care needs, and costs provides the best opportunity to avoid the unexpected. The stress of aging, experiencing health issues, and feelings of losing control are significant for an elderly adult.

Adult children who become the medical power of attorney or who are caregivers for elderly parents experience similar stresses. Working caregivers struggle to find a work-life balance with the role of being a medical power of attorney or a caregiver added in. Adult children with young children are stretched and sandwiched between caring for elderly parents.

In caregiving situations, there is an abundance of stress and worry that goes around. By becoming more educated and learning what family caregivers don’t know about being a medical power of attorney, family caregiving relationships can be more positive. Elderly parents will feel more confident that their wishes and desires will be met and that there are a financial plan and a back-up plan for care.

Looking for More Help With Caregiving Responsibilities? You’ll Find What You’re Looking For in The Caring Generation Library Section Difficult Discussions

© 2019 Pamela D. Wilson, All Rights Reserved. 

Pamela D. Wilson, MS, BS/BA, CG, CSA is a national caregiving expert, advocate, and speaker.  More than 20 years of experience as a direct service provider in the roles of a court-appointed guardian, power of attorney, and care manager led to programs supporting family caregivers and aging adults who want to be proactive about health, well-being, and caregiving. Wilson provides education and support for consumers and corporations interested in supporting employees who are working caregivers. To carry out her mission, Wilson partners with companies passionate about connecting with the caregiving market through digital and content marketing. Her mission to connect with caregivers worldwide happens through the social media channels of Facebook, YouTube, Linked In, Instagram, Caregiving TV on Roku, and The Caring Generation® radio program. She may be reached at 303-810-1816 or through her website

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