What is a healthcare surrogate?
A healthcare surrogate is someone designated to make healthcare decisions for you. Here’s the Florida statute covering healthcare surrogates. Sometimes this is also referred to as a healthcare Power of Attorney.
It is different from a Durable Power of Attorney, which covers financial decisions, contracts, etc. As you will see in the responsibilities below, there are some areas where these two may overlap/affect each other. Therefore, many people appoint the same person. When different people serve in these roles, there will almost always need to be cooperation to carry out the duties of each.
Here’s the official definition of a healthcare surrogate from the Florida statutes:
“Surrogate” means any competent adult expressly designated by a principal to make health care decisions and to receive health information. The principal may stipulate whether the authority of the surrogate to make health care decisions or to receive health information is exercisable immediately without the necessity for a determination of incapacity or only upon the principal’s incapacity as provided in s. 765.204.
What are the responsibilities that come with being healthcare surrogate?
Here are the responsibilities outlined in the Florida rules (unless authority has been expressly limited by the principal):
- Have authority to act for the principal and to make all health care decisions for the principal during the principal’s incapacity.
- Consult expeditiously with appropriate health care providers to provide informed consent, and make only health care decisions for the principal which he or she believes the principal would have made under the circumstances if the principal were capable of making such decisions. If there is no indication of what the principal would have chosen, the surrogate may consider the patient’s best interest in deciding that proposed treatments are to be withheld or that treatments currently in effect are to be withdrawn.
- Provide written consent using an appropriate form whenever consent is required, including a physician’s order not to resuscitate.
- Be provided access to the appropriate health information of the principal.
- Apply for public benefits, such as Medicare and Medicaid, for the principal and have access to information regarding the principal’s income and assets and banking and financial records to the extent required to make application.
A few other important points to know from the statutes:
- The surrogate may authorize the release of health information to appropriate persons to ensure the continuity of the principal’s health care and may authorize the admission, discharge, or transfer of the principal to or from a healthcare facility or other facility or program licensed under chapter 400 or chapter 429.
- If, after the appointment of a surrogate, a court appoints a guardian, the surrogate shall continue to make health care decisions for the principal, unless the court has modified or revoked the authority of the surrogate pursuant to s. 744.3115. The surrogate may be directed by the court to report the principal’s health care status to the guardian.
Essentially, a healthcare surrogate is much as the name implies. This person is acting as a surrogate decision maker and manager of the healthcare on behalf of the person who designated them. As you can see, it’s a pretty serious role with heavy responsibilities.
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Challenges of Being a Healthcare Surrogate
As we covered before, becoming a healthcare surrogate and/or durable power of attorney for someone can be a challenge. This is especially true when you don’t know the person’s wishes or if there’s conflict with others involved. It can be stressful and all-encompassing. These types of decisions are not only serious, they often need to be made quickly. The role is 24/7, as a healthcare surrogate may be called on to make decisions during a crisis. It isn’t unusual to have to rush to the ER late at night or to receive calls from care facilities on weekends or holidays.
Others may question the decisions you make as healthcare surrogate. Note this provision in the healthcare surrogate statute:
The patient’s family, the health care facility, or the primary physician, or any other interested person who may reasonably be expected to be directly affected by the surrogate or proxy’s decision concerning any health care decision may seek expedited judicial intervention.
This can be done for various reasons, such as decisions not being done in accordance with the patient’s known desires, the patient changing their mind or vagueness of documents, improper execution of the document or it being revoked, abuse of power, and more.
Benefits of Working with a Care Manager When You are Healthcare Surrogate
A Care Manager is a specialized professional, with a background in social work, nursing, mental health, and/or gerontology, who acts as a guide for families/individuals with care needs. Families and other responsible parties can count on professional Care Managers to offer expert guidance and help them more seamlessly navigate the challenges of aging and caregiving.
When you’re a healthcare surrogate, a care manager makes a natural partner to help you ensure the best care for the person who has designated you. They offer a sounding board, help with advocacy, and coordination. You and the patient/principal benefit from their years of experience. You can also hire the care manager to be on call for you, to more easily deal with the 24/7 nature of the role. A healthcare surrogate should consider either an ongoing relationship with a care manager to help coordinate or a consultation initially and during any periods of significant change, transition or major decisions.
Working with a care manager also offers a level of protection, particularly where conflicts or concerns already exist. Using a care manager shows your careful consideration of decisions and provides useful documentation. The intervention and mediation of a care manager often prevents worsening conflict that could lead to guardianships, lawsuits and more.