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Health Care Advance Planning: Selecting your power of attorney agent when loved ones are far away

Planning your end-of-life care options is difficult yet necessary. It is your right to make health care decisions for yourself and you can plan now for your medical care if you are unable to speak for yourself in the future. Visiting with an attorney to discuss completing an Advance Directive is your first step. Whether you are just beginning to plan or are revisiting a plan you developed long ago, the time to finish or update this task is now.

Without the legal designation of a person to speak for you if you are not able, your wishes may not be honored. If your closest loved ones live far away, or are unwilling or unable to speak for you, it may be wise to plan for an alternate person who lives local to you, and consider a professional to fill that role.

What is a power of attorney for health care agent?

A “power of attorney” is the documented assignment of a person, the “agent” you name who has the power to manage your affairs. For health care, this person is designated to represent your decisions if you are unable to make your decisions known. There are a variety of reasons why a person may be unable to make their decisions known. Some reasons are obvious, such as unconsciousness, and others can be an indication of a slow decline due to dementia or other ailment of adults as we age.

Most Americans die in an institutional setting, from a decline in health. Planning for this decline in health and capacity will benefit you and those you love near and far. Having someone close by and involved in your life, who will monitor your care if you are infirmed, can help you rest, reducing the stress and fear you may encounter. Your assigned power of attorney for health care agent is a natural person to have included in your care before you become infirmed or begin to decline. Planning for this protection may help you stay in your home longer as you age.

Who can you select as your agent?

The usual recommendation is to select a primary health care agent and an alternate. In the event your primary agent is unavailable the alternate can step-in to serve. They must be over 18 years of age, be willing to serve in this role for you, be able to act on your wishes separate from their own, be someone you trust, and be capable as a strong advocate handling conflict and differing opinions. Your health care provider or their employee may not serve in this role.

Often times spouses select one another as their health care agent and a responsible adult child as their alternate. As time progresses and the realities of aging-in-place become known, adult children sometimes find themselves too far away and with the realization that one parent may not be available for the other.

You may consider having your adult child as your primary health care agent and ask a close friend who may live nearby and who has similar beliefs and values to be your alternate agent. This way you have someone local to check-in on day to day concerns until it becomes necessary for your adult child to travel to you.

You may also choose not to burden your family or friends. Maybe your children are busy in their own lives or you want to avoid conflict among family members. Or, if you are concerned that your spouse, adult child, or a friend may not be suitable or competent to serve as your health care agent, you might consider selecting a licensed professional fiduciary.

Why select a licensed professional fiduciary?

Licensed professional fiduciaries can serve as your agent for power of attorney for health care and also for finances. Some fiduciaries specialize in serving as either health care agent or finance agent as your trustee.

When it comes to matters of a person and their health care, licensed professional fiduciaries are involved with seniors, and people with disabilities who select them as their health care agent for managing their daily and medical care. Fiduciaries provide critical services to help protect and maintain quality of life for people. They identify when to bring in help from other professionals to manage a person’s care at home, and consult with doctors and attorneys as necessary.

In California, fiduciaries are licensed and regulated by the state of California’s Professional Fiduciary Bureau under the Department of Consumer Affairs. You can learn about the high standards and stringent requirements licensed professional fiduciaries are held to by visiting their website at


If you find yourself with no clear person to select as your health care agent, consider choosing a licensed professional fiduciary who specializes in you as a person.

Lori Cochrane is a licensed professional fiduciary and a professional power of attorney for health care agent. She specializes in all matters of the person and practices a person centered philosophy as a health care advocate. She has been helping families during times of difficulty and transitions since 2000. Lori can be reached at 916-705-7309 or

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