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When Clients Lack a Clear Choice for Their Healthcare Proxy

Four options to ensure clients get the care they want no matter the circumstances.

Last month I wrote about why it is crucial for all of your clients to have a healthcare proxy in place and the necessary steps to make sure the proper documents are completed.

But what happens if your clients don’t have anyone they trust to make healthcare decisions on their behalf? They may be the only surviving relative, or they may be part of a dysfunctional family. Even in a healthy situation, they may lack family or friends willing to take on the responsibility of making such crucial decisions, or who disagree with the choices your client would make. Whatever the case, your clients still have options to help ensure they get the care they want no matter the circumstances of their lives.

  1. There is a growing field called Professional Fiduciaries. Some states, such as California, have developed an association of such fiduciaries. These are people who are certified and trained to learn and carry out the client’s medical wishes during times when the client is incapable of making or communicating their own decisions.

  2. Ensure your clients have a very thorough and detailed living will even if they don’t have a healthcare proxy named. Clients who choose this route are de facto appointing their doctors as healthcare proxies. Consequently, it is imperative that clients have the same in-depth conversation with their doctors that they would have with any proxy, so there is a clear understanding of their wishes. They also need to ensure that updated copies of the detailed living will are on file with all of their doctors and hospitals, their lawyer, and anyone else who may need to either produce a copy or make a decision.

  3. If the service is available in their area, clients may appoint as healthcare proxy a geriatric care manager (a social worker who specializes in helping seniors manage their care). Care managers are familiar and comfortable with senior care, and are sometimes even more likely to carry out the person’s wishes because they don’t have the emotional attachment of family members. Care managers do charge to act in this capacity, but it is typically a far lower rate than an attorney’s fee.

  4. The least attractive option is to appoint an attorney. It can sometimes be difficult to find attorneys willing to take on such an important role and those who do sometimes charge hefty fees for agreeing to carry out such serious responsibilities. Yet it can work if clients know and trust the attorney and can have those all-important conversations with them ahead of time.

The most important decisions affecting a patient’s treatment and care are made in the final weeks, months and years of life. At other times, decisions may need to be made when clients are temporarily unconscious after an accident, injury or surgery. Yet too few people ever talk about or write down how they want those decisions to be made.

When you educate your clients, facilitating the completion of advance directives, guiding them to choose healthcare proxies wisely even when they are without an obvious choice for an appointee, and encouraging the all-important discussions that inform all those affected, then you ease their fears and keep them in greater control of how they choose to live. The resulting peace of mind is invaluable to your clients and consequently good for your business.

Amy Florian is the CEO of Corgenius, combining neuroscience and psychology to train financial professions in how to build strong relationships with clients through all the losses and transitions of life. 

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