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Half of us 65 and above arrive at the hospital unable to direct our own care. We’re not delivering a baby or visiting the ER because we got hit too hard by a baseball playing catch. We’re sick. And, often as not, we need someone who can speak for us, who can be our voice.

But who should that be? And what should they say?

Unless you have a diagnosis and a prognosis, medicine is changing too fast to carve your choices in stone, enshrining specifics in a document. Consider your values. Discuss them with your family and physician. Document them in a letter attached to your Medical Power of Attorney.

  • How important is independence and self-sufficiency? How much can you adjust to the interdependency of family life? (When mom moves in.)
  • How much do your want the person who speaks for you to rely on health care professionals? 37% of the time an initial diagnosis misses something. When should they get a second opinion?
  • What kind of living environment is important to you? Would you be willing to downsize? To move near to or in with a child? What are the “must haves” in an assisted living or skilled nursing facility? (Checklist for evaluating senior facilities.)
  • What role do you want your religious beliefs to play? Do you want visits by clergy, certain prayers or poems or music?
  • What medical care do you want? (Stay in charge of your medical care.)
  • What other kinds of care? Certain foods? Massage? Certain clothes?
  • Who do you want to take care of you?
  • Where do you want to be and with whom?
  • What questions should your agent ask the doctor? What should they consider in speaking for you?
  • Do you want to decide in advance what should happen if you are found to be in a permanent vegetative state? Thought to have only six months to live? 62% of Americans die in pain. Are there certain interventions which you would find too painful? (Making health care decisions for a loved one.)

When you are not able to speak for yourself, you need someone who will stand up for you and for what you want, regardless of what other family members or the doctors say. Who can do that? If they can’t get to the hospital quickly, who could be a backup? This is one time you cannot afford to have things fall through the cracks.


Elder law attorney, Terry Garrett, is a member of the National Academy of Elder Law Attorneys and is an Approved Guardianship Attorney. She assists people in elder law, estate and special needs planning, guardianship and settling estates. She graduated with honors from Cornell University. She was on the Dean’s List at Wharton Business School. She earned her J.D. at Columbia Law School, receiving the Parker Award and a Mellon Fellowship.

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