What is a health care proxy and how to get one

[MUSIC PLAYING] How tough is it to get a health care proxy? It's one of the most simple things you can do. You just assume that you can still continue to make medical decisions for them if they get in an unfortunate situation, but that's actually not the case. Why isn't this top of the list for every parent? I think it's mostly that people just aren't aware. You just don't know if the worst is going to happen to your family. Married, single, young, old, everyone should have one. Today, we're talking about health care proxies for adult children or, frankly, anyone that doesn't have one. We're going to cover what a health care proxy is, how to get one, and the critical conversations you need to have as part of the process. Hi, welcome to Money Unscripted, a podcast from Fidelity Investments. I'm Ally Donnelly. When it comes to or your child's health care, this one document could make all the difference. The Bakers know that all too well. So now they're on a mission to help other families and honor their daughter's memory. Baylie loved the beach and she loved the water. It's been five years since Shawnee and Scott Baker lost their daughter, Baylie Grogan. Baylie was the epitome of what you'd want in a daughter. She was smart, fun, outgoing, caring. Baylie was just 18, studying to be a neurosurgeon at a Florida university. She was very compassionate, but yet, she had a really silly side. She did. And she made people laugh. Baylie was heading into her sophomore year and had just returned to campus from the summer. She went out with friends for a 21st birthday party. Coming home, she was hit by a car crossing the street. He said, "Your daughter's been in a terrible accident. She's been hit by a car. You need to come now." And that's when my heart stopped. Knowing very little, the Bakers rushed to the hospital in Florida. They were frantic with questions. The hospital had told them she was in surgery, but weren't telling them the extent of Baylie's injuries, the plan, the prognosis for their oldest child. When you ask for details, unfortunately they said, "We can't share that with you." The response is, "What do you mean you can't tell us?" Hospital staff told them they couldn't share information because Baylie was 18, a legal adult, and didn't have a health care proxy. That's a legal document that names someone who can speak for you, make decisions for you if you're too sick or hurt to make them for yourself. The officers and the medical staff literally legally could not share her situation with us. The Bakers argued, "She's our child. She still lives with us. She's on our insurance. We should be the ones making the decisions for her." But the hospital's hands were tied. The law is the law. Baylie's life was basically in the hands of the ethics committee or the ethics board of the hospital. And you can observe and listen. And they'll ask you your opinion, but at the end of the day, that's their call. What did that do to you, I mean, as parents? It's incredibly frustrating. And it's just-- you're in such a fog. You just-- you just don't know what's happening. And then to be kept in the dark further, it's even harder. Scott, Baylie's stepfather, says he should have known to get a health care proxy for Baylie when she went off to college. He's a certified financial planner and says talking about health care proxies is a natural conversation he has with his clients. But more often than not, those conversations are focused on older people. You just don't contemplate this for your teenage kids. When you're sending your kids off to college, you're worried about what clothes they have and getting them down there and setting up their dorm room and things of that nature. The notion of, oh, we have to get a health care proxy, too? Just doesn't even dawn on anyone. In the end, having a health care proxy couldn't save their child. After an agonizing six weeks of surgeries and disappointments, Baylie remained in a coma and was eventually taken off life support. It was a gut-wrenching decision that the Bakers supported, but because they didn't have that health care proxy, it was the ethics board, not Baylie's parents, who made the decision. It just-- it felt like torture is what it felt like to us. You just-- you can't fathom it. And no one thinks it'll be their child. Yeah. No one thinks it'll happen to them. Whee! Shawnee and Scott, who have two other daughters, have started a foundation in Baylie memory, educating parents and others on the importance of health care proxies for unmarried adult children. We were put in a position we never expected to be in. And I just can't see any other family having to go through what we did. And what's your hope once people see this piece? Our hope is that just this becomes just a matter of course. Just like getting your driver's license or getting your voter registration card or enrolling in college, this is just something that every family does. When you turn 18, this is what you do. What do you think Baylie would think of this work? She would be proud of it, she would. If she was here, she would be a big part of this. So we have to be her proxy. We have to do this work for her. Baylie's story is painful to hear, but so very important in a family's overall planning process. I want to welcome David Peterson. He's the head of Advanced Wealth Solutions here at Fidelity, and he's going to help us navigate every step of the process. David, thank you for being here. Great to be with you. David, no one wants to imagine worst-case scenarios for their children or their families, but accidents like Baylie's can happen, or even more mundane things where an adult can't advocate for themselves. How does the Bakers' mission to educate other families about this strike you? Well, the Bakers' experience is heartbreaking, but when it happens unexpectedly, when it happens dramatically, when it happens to someone young, and when you don't have information or control over the circumstance, it makes it that much worse, I think. Yeah. And to me, their mission about getting people aware of health care proxies is a really important mission. Yeah, you talked about information. So let's level-set for a minute. Give us the definition of a health care proxy. Right. Well, a health care proxy is really just a simple document that allows someone to act on your behalf in the circumstances when you can't. So important only when you can't advocate for yourself? Correct, correct. And it's also important because of the HIPAA regulations. We talked about information, medical professionals can't share with other people what is considered private information, and your medical information is private. So is it the same thing as a power of attorney? I mean, if you have power of attorney, are you covered, so to speak? Well, power of attorney is a very generic term-- or phrase. It applies to-- it can apply to a lot of different scenarios. So I can have a power of attorney over financial decisions, I can have a power of attorney over legal matters, and I can have a power of attorney over health care matters, which is what we commonly refer to as a health care power of attorney, a health care proxy. There are a lot of different similar phrases that accomplish the same things. When you consider Baylie's story, why isn't this top of the list for every parent? Yeah, it's a good question. I think it's mostly that people just aren't aware. When you think about children, college-aged children, you've just spent the first 18 years of their lives speaking for them, deciding for them. You're their guardian in every respect. The law says when they turn 18, or when they reach the age of majority, they're their own person. And so in their situation, they were put into this event where they were acting-- or thought they could act as they did for the first part of Baylie's life. Yeah, yeah. And now they couldn't. Yeah. Yeah, they were shocked. I mean, really shocked. So to me, it's like, people just don't know that they have to take this action. And let's face it, people aren't really expecting to have to take this kind of action. To me, it's like an insurance policy. Insurance is for things that happen infrequently, but there's a high cost to them when they happen. Yeah. And so to me, a health care proxy is a really low-cost way to have a good insurance policy. I know every situation is different, but let's lean into that for just a second. Like, what could be an entree into that conversation with your child? I would go brass tacks. You're going away to school, here's a checklist of things that we need to do. Health insurance, renter's insurance, car insurance, all the things that we've taken care of for you traditionally, we now need to transfer to you to own yourself maybe the way the conversation goes. One of those things is thinking about health care proxies. Let's say something unexpected happens to them. They're injured, for example, and they can't make decisions on their own, you want to have a health care proxy so that you can make decisions on their behalf. Without one, you'll have no say in the matter. Even though I'm their parent, even though they're on my insurance? Even if you're their parent, even if you're their guardian, even if they're on your insurance, they're now an adult. And the law says, when you're an adult, you need these in place. And the hospital would make the decisions, not me? Correct. These important conversations, they always feel so much bigger before you have them, but this can be a difficult one to talk to your kids about. Or anybody. Yeah, I think it could be difficult to talk to anyone about. I think-- I would actually argue that with children-- or college-aged young people, it's probably an easier conversation. Again, because no one's expecting to ever have to actually use it. I think it's more difficult as people get older. Yeah. Because as we get older, we start to think about our own mortality and morbidity, and those are things we don't want to think about. But when I'm 18, when I was 18, I was not thinking about these things. Right. So had my parents come to me and said, "We're going to have you sign this health care proxy," I would have been like, OK. Right. What's the difference between a health care proxy and a living will? Right. So the health care proxy gives someone the authority to act on your behalf. The living will is basically your desires of what you want to have happen related to your care. This is usually mostly around end-of-life, life-saving kinds of things like, do you want to-- do you want them, the medical professionals to take all actions to save your life or not? Right. Do you want a feeding tube? Do you not? Do you want a respirator? Do you not? And so what it's intended to do is guide the person who is your agent so that they understand when they are making decisions on your behalf the guidelines on which they should be acting. Got it. We've talked about Baylie and the Bakers and that situation. But this isn't just a conversation for young adults. No, it's for everybody. In fact, it's one of the core documents that we recommend for everyone to have when they think about their estate planning. Married, single, young, old, everyone should have one. And who should be your health care proxy? I mean, do I automatically think I would be the health care proxy for my teenage daughter? Or are there other things to consider? Yeah, no, it's a great question, and I think, not to cop out on my answer, but it's unique to any individual. The core thing is it can be any competent adult that can act on your behalf. What I think you want to think about is, does the person have the mental and emotional capacity to make the decisions that you're going to ultimately be asking them to make? It's a big responsibility. I can give you the example with my dad when he was at the end of his life. He was signing a health care proxy then. Now he was still competent, but he was ending-- he was coming to the end of his life. And his wife was going to be his health care proxy, quite naturally. And she actually said to the rest-- to me and my siblings, "I'm signing this, but I'm not making this decision on my own because I'm not sure I can." So there you have it. And this is actually an important point. A lot of people ask, can I make multiple people my agents? You can. I'm just not sure it's a great idea. And if you think about the medical professional on the opposite side of the table who's looking for a decision to be made, they usually want one person making that decision. They don't want to necessarily have to go to a committee of people who may not agree, by the way, on what the path forward should be. Right. Yeah. That's a tough one. So if I choose someone to be my health care proxy, how long is it-- I mean, how long does it endure? Like, is it-- what do I do? Yeah, they don't really expire. Usually when you sign a health care proxy, the language in the form states that you're revoking all the prior authorities that you've issued. The important thing to remember there is if you have had one before that named a different agent and you've shared that with your medical professionals, you probably want to share the new one with them and say, hey, I've signed a new one, I've revoked the old one. OK. Here's the new one. Let me go into that. So how do you-- like, if I get divorced or I have a falling out with a person who's on my health care proxy, how do I revoke or cancel it? What's the process. Well, so it's going to differ by state. So if you're thinking about married couples in particular, sometimes in some states, a divorce or separation automatically removes the agent and it would go to whoever the successor agent is if you've named one. In other states, the whole document gets revoked automatically. So you really need to look to the state law to say-- to determine what happens. Right, right, that makes sense. Let's talk brass tacks. I want to establish a health care proxy. Start me from the beginning. What do I do? It's pretty simple. Most states actually have forms online. It's usually a one or two-page document. And while it is a legal document, you don't need an attorney to draft it for you. Like I said, most states have the form that they've created for their state that allows this transfer of power, essentially. And usually, it needs to be signed by two witnesses. And oftentimes there's a notary to verify that the people signing it are the people who they claim they are. Yeah, yeah. But that also varies by state, so again, you probably want to just look to your state. And all this is online, so go to the state's website. Does it cost anything? It's a legal document, but you don't have to have an attorney draft it for you. The states provide it for you. It's a simple form. OK. So I might pay a notary, but beyond that-- Exactly. That's what I was just going to say. You might have to pay a notary a small fee to do the notarization, but generally no. OK, I have this form. Yeah. Once I've filled it out, what do I do with it? Well, you definitely don't want it in a safe deposit box. You want it readily available. Again, medical emergencies, decisions need to usually be made quickly. So you want to give a copy to your agent because you want to know that-- they want to know the responsibilities that they have. When you say agent, I just want to clarify, that's the person? That's the person. OK. Yeah. You want to give it to the person that you're giving this responsibility to so that they have it on hand in case they need to show evidence of it at the hospital or with your doctor. You want to probably give it to your caregiver and maybe to your local hospital that you're using so that everyone knows what the situation is. But there's no place I need to officially file it? No. No. OK. It just needs to be readily accessible. OK. Imagine if something happened and your health care proxy is in your safe deposit box. Right, right. I don't know where the key is. Right. OK. Yeah. End of story. Like, they're not going to be able to act on your behalf. They have to show evidence that you've given them that authority to do it. And then you could be in a situation like the Bakers? Right. Yeah. OK. It's interesting because everyone I share this story with, they're like, oh my gosh, I've got to get that done. Right. But so many people haven't done it or don't do it, and it just is so easy. Yeah, I just think it comes from a place, again, people aren't aware of it. You've spent your whole life speaking on behalf of your children. And just because they go away to college doesn't make you think that they're not children anymore. They're always your children. And so I think, in our minds, that means, well, I can still make decisions for them. Unfortunately, the law says no. Any final thoughts that you want to leave folks with? My thought is that this is-- again, it's one of the core documents that we recommend for everyone. We've been focused on younger people and college-aged people, but it really applies to everyone. Married, divorced, young, old. Really, everyone, in my opinion, should have a health care proxy. David, thank you so much. It's been such a valuable conversation. I appreciate it. Always a pleasure. And a special Thanks to the Baker family for sharing their story with us. For information on their foundation that's working to educate families on the importance of health care proxies, head to our website at Fidelity.com/MoneyUnscripted, or check out the show notes. You'll also find articles on key estate planning documents and links to all of our other episodes. Be sure to like, follow, subscribe to Money Unscripted because it's your life, get your money's worth. [MUSIC PLAYING] Disclosures Information presented herein is for discussion and illustrative purposes only and is not a recommendation or an offer or solicitation to buy or sell any securities. 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