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What exact authorities does the invoked health care proxy have?


I assume it is right to privacy of the loved one (limitating who attends family meetings, protecting confidential health information and/or who to share it with), taking part in medical decision making, signing consents for medications with black box warnings (not all facilities I notice ask for consents) or certain procedures especially those involving research, hiring home care services though the loved one may not want them, deciding which short-term rehab and possible long-term facility for the loved one to go to, designate the alternate health care proxy to be acting and/or appoint someone else, etc.?


Can a physician or health care provider overturn a health care proxy's decision relating to certain medications? I read that the health care proxy is really philosophical; that the health care team can overturn the health care proxy's imput any time.


Any others? I would like to hear your feedback.

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dnajaras: This discourse should be stated/asked of your attorney, which JoAnn29 said that you retained/spoke to on Tues., the 30th. Thank you JoAnn.
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This OP had an aplt with a lawyer on Tues the 30th. They have chose not to update us on what they found out.
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Honestly, you may want to consider having this conversation with an
" Elder Law " Attorney. In fact, anyone completing " end of life" documents to express their wishes and who can speak for them and when etc , may be best conferring with an Elder Law Attorney.These documents may vary based on several variables such as what if any specific directions/ wishes the person has included when preparing the documents.
Also " interpretation" of a document may vary. And, even geographic, locations/ states/ countries etc may be another variable.
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Any legal documents has the rights enumerated on the document itself. For any real power over someone diagnosed and judged incompetent is a full POA. A health care proxy often amounts to no more than carrying out an advance directive written by the principal him/herself directing doctors that in the event they cannot make their own decision they will not accept this or that heroic measure.Read your document to see what sort of things you have signed to do for the person assigning you. There is nothing "philosophical" about waving a person's advance directive in front of MD about to intubate when a patient said they did not want intubation. It's pretty crucial. As Health Care Proxy you are doing exactly as, and only as your principal dictated before death. For instance my own advance directive says that in the event I cannot make my own decisions I do not wish to have dialysis, even temporarily, I do not wish to have life sustaining nutrition administered by IV or NG or PEG. The proxy can carry forward those wishes.
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ElizabethAR37 Jun 2023
I totally agree! One of my greatest fears is that my very clear advance directive, plus a detailed written personal letter, will not be respected by the medical industrial complex. Wish Zurich wasn't so pricey.
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Agree with others who say it depends on what is written into the document. My husband is MPoA for his Mom in a good, local LTC facility. They don't do anything without consulting him first. I think it also depends on how well-trained medical staff is at facilities.

I'm MPoA for my 94-yr old Mom. Cognitively she is still pretty good, but can get confused by medical instructions. She still had to fill out a HIPAA Medical Representative form for me at every clinic so that the team could legally share her information with me without her being present.

As far as it being philosophical... maybe you are gettting it confused with a Advance Healthcare Directive? But this document still does have legal weight as well.
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My husband is health care proxy (HCP) for his dad. He has started directing his dad's care because some doctors were approaching my FIL's condition very aggressively, wanting to "do everything" and add pills when there was no clear benefit.

Hubby accompanies his dad to appointments and is the one who asks the questions. He recently said no to a neurologist wanting to add Xanax, for example. He also put a stop to the dentist wanting to see my FIL every 3 months and who always found something expensive to do in my FIL's mouth.

I think my husband has been successful at curtailing unnecessary treatment and meds is because he can physically be present and challenges them when they don't have a reasonable explanation but rather are just throwing things at the problem hoping something sticks.

As for APRNs, many are wholly unqualified to be directing care.
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It very much depends upon how the HCP is written.

I found this, which applies to NYS:

https://assembly.state.ny.us/member_files/075/20110719/

As I've mentioned, my brothers and I were all Mom's HCP. Did the hospitals/facility always follow our instructions/notify us? No.

One over-zealous APRN reduced mom's dosage of previously agreed upon dosage of antidepressants and antianxiety meds without informing us. When my SIL, who visited mom several times a week, noticed that mom was weepy, we had the DON review her meds. We requested that that clinician no longer allowed to change medications without informing us. (Ask me how many hours I was on the phone that week).

I don't recall anyone ADDING any meds without our permission.

A bit of history --when mom first moved from her single family home, it was to an Independent Living facility close to where she lived, but an hour at least from each of us. After she had a stroke, we agreed she needed to be close to ONE of us for better response time (from us); we moved her to a rehab and later a NH home that was about a 15 minute drive from one brother.

If your mom is going to need to be in long term care, I think it behooves you to move her closer to you.
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