A myeloma diagnosis is a life-changing event that can alter the way you think about your future. Having cancer can put life into perspective and bring up issues that you may not have thought about, including how you want to be cared for if you cannot advocate for yourself.

Many people struggle with advance care planning, such as creating a will or filling out advance directives. But planning for your future ensures that your wishes are fulfilled and gives your loved ones guidance in the face of challenging end-of-life care decisions. Familiarizing yourself with the process of designating a medical power of attorney (POA) agent will help you appoint the best person for this important job.

What Is a Medical POA?

A medical POA, sometimes called a durable POA for health care, is a legal document that gives another person the ability to make medical decisions on your behalf if you’re unable to make these decisions. In the United State, specific laws vary from state to state for setting up a medical POA. The person you choose to represent you may be referred to as your:

• Health care agent
• Health care proxy
• Health care surrogate
• Health care representative
• Health care attorney-in-fact
• Patient advocate

A medical POA agent must follow any predetermined guidelines that you specify. However, this person can make significant life-sustaining treatment decisions, including whether to keep you on life support or discontinue medical treatment.

How Do You Designate a POA?

One member of MyMyelomaTeam talked about completing their paperwork on their own because their husband wasn’t ready to face their diagnosis.

“I still need to get a living will and medical POA. I would hate for this to take a turn for the worse, and my loved ones have to make that decision for me,” they shared. “My husband does not want to talk about those things because all he heard from the doctor is everything will be fine. I know if I tell him I am not fine, he will be the first one at my side rushing me to the hospital or doctor’s office, but he will not worry about it until then. So, I have to do all the planning on my own.”

Fortunately, for most parts of the United States, there’s a simplified form you can use to designate your health care agent. This bare-bones multistate form is valid in every state except Ohio, New Hampshire, Texas, and Wisconsin. Each of these other states has its own mandatory disclosure statement.

You should be able to find medical POA forms on your state government’s website. Most states don’t require a notary, but typically two witnesses must be present to certify that you signed the forms. Different states have specific rules on who can serve as a witness, so be sure to read the terms carefully or seek legal counsel to help you.

While selecting a medical POA agent, you may also want to put other legal documents in place that define the type of medical treatment you want, how your bank accounts will be managed, and who will care for your children (if applicable). As one MyMyelomaTeam member said: “I have both medical and financial POA for my mom, who at 83 is about to be diagnosed. I am trying to learn everything I can as fast as I can, so she can have the best quality of life possible.”

Potential Benefits and Risks

Although thinking about an uncertain future can be difficult, preparing a medical POA and choosing an agent can reduce the burden on your loved ones if your health declines. Taking these steps can also give you peace of mind, as many members of MyMyelomaTeam have noted. As one member shared, “Getting these documents in order is a hard thing to do, but so important. I made binders for the important documents, making it easy for my daughters when needed. It’s a good feeling to get it done.”

Another member said, “I also got my documents done. It’s a good idea these days, with or without myeloma. 💞”

Outlining your preferences in advance directives gives you better control over your medical care. However, health care situations can be complicated, and having a trusted person who can act as your advocate will help your care team navigate unforeseen circumstances.

By making decisions in advance — or choosing someone who understands what you want — you can prevent others from grappling with difficult choices about your care or from having regrets. Be sure to inform the person you choose as your agent so that they can be prepared and available if called upon. Let your loved ones know your reasoning for choosing this person, and encourage them to support your agent in fulfilling their decision-making responsibilities.

If you don’t choose a medical POA agent, an agent may be chosen for you. The following people are legally authorized to make decisions about your health care (in the order listed) if you’re incapacitated:

• Any guardians or conservators previously appointed by a court
• A legal spouse or domestic partner
• An adult child
• An adult sibling
• A caregiver (who is not your health care provider)
• A close friend or nearby relative

If you don’t want any of the above people to have power over your care, it’s important to put paperwork in place to specify that choice. Designating a medical POA agent ensures that your preferred person or people will be in charge of communicating about palliative care and other treatment options with your oncology team.

There’s always some risk involved when you give another person legal authority over your rights. However, medical POA won’t come into play unless you don’t have the mental capacity or ability to communicate. A doctor must verify your inability to make health care decisions before your agent can intervene. You can also set limits on the types of medical decisions your agent can make for you, and they must follow any instructions you’ve provided. If a court believes that your health care agent is not acting in your best interests or in line with your previously designated desires, the right of medical POA can be revoked.

Choosing the Right Person

The rules may vary by state, but in general, a person must meet a few criteria before they can be given medical POA. For instance, your agent must be older than 18 years of age or legally emancipated. The person can’t be your health care provider or your residential care provider (if you live in a health care facility or nursing home). In addition, the person should not be related to your health care or residential care provider.

Steer clear of choosing anyone you don’t fully trust or don’t believe can handle the responsibility. There’s a lot to consider before signing a medical POA document, including whether you feel the other person is up to the task. Just because someone cares for you doesn’t mean they’re the best choice to act as your representative.

Examples of the people who are typically appointed to be health care agents include:

• A close friend
• A family member
• A member of your religious community
• A trusted neighbor

Ideally, you should choose a medical POA agent before your health comes into question. Because circumstances may change over time, you have the right to change your agent or revoke your agent’s rights as long as you’re still capable of making your health care decisions. If a spouse was given the POA, they may have this right removed if a divorce occurs. Be sure to read through the terms, or request a referral to a lawyer or social worker who can explain the ins and outs of your medical POA document before signing.

Talk With Others Who Understand

MyMyelomaTeam is the social network for people with myeloma. On MyMyelomaTeam, more than 13,000 members come together to ask questions, give advice, and share their stories with others who understand life with myeloma.

Have you designated a medical power of attorney? How did you choose the right person, and what was the process like? Share your insight in the comments below, or start a conversation by posting on MyMyelomaTeam.