Differences between HCPOA, MHCPOA, LW

 Unfortunately, our nation has seen several public examples of what can happen when there are no healthcare or end-of-life directives in place. To avoid situations like Terri Schiavo and others- putting the right medical directives in place can save hundreds of thousands of dollars in court fees and medical treatment, as well as heartache for family.  Arizona has two types of health care powers (medical and mental), in addition to allowing for creation of a Living Will.  A brief description of the differences in these documents is outlined below:

Remember Terri Schiavo? She was the brain injured young woman in Florida whose husband and parents engaged in a nationally publicized eight-year court battle over her end-of-life medical treatment. If she had advanced medical directives in place, we likely would not know her name.  

Healthcare Power of Attorney

A Healthcare Power of Attorney (“HCPOA”) names an Agent to make healthcare decisions for you when you become unable to make decisions yourself.  Your Agent is able to consent to medical care and to make necessary decisions regarding life-sustaining treatment.  In Arizona, the nominated Agent under your HCPOA does not have the ability to admit you to an inpatient psychiatric hospital facility, the type of facility where those who are seriously mentally ill or have advanced cases of Alzheimer’s or other forms of dementia with psychiatric behaviors might need diagnosis and/or periodic in-patient treatment.   

Mental Healthcare Power of Attorney

The Agent named under a Mental Healthcare Power of Attorney (“MHCPOA”) can apply for admission to an inpatient psychiatric facility for evaluation and treatment without going to court.  If mentally ill, the Principal cannot easily revoke the power because the principal agrees in the document itself that if he or she is determined to lack ability to give informed consent, he or she cannot revoke the document or disqualify the agent. There are several in-patient mental health treatment facilities in the Phoenix metropolitan area which only treat seniors. We encourage all our clients to have a mental health power of attorney in place, either separate or combined with the HCPOA, just in case of need.  However, someone diagnosed with dementia of any type should have this document in place as persons with dementia, Alzheimer’s disease or Lewy Body diseases are more likely to need this type of treatment than the general senior population.    

Living Will

A Living Will is a written statement meant to communicate end-of-life wishes if you were unable to communicate those wishes yourself.  The document memorializes desires regarding medical treatment or action used to delay death in terminal conditions.  This document also outlines wishes in the event of a persistent vegetative state or irreversible coma. A Living Will is not a decision-maker itself.  For instance, it does not permit health care providers to stop tube feeding- only an Agent appointed under a HCPOA or a court-appointed Guardian may make such a decision.

Everyone over the age of 18 should have each of these above-mentioned documents.  Once in place, the documents should be reviewed periodically to ensure they are up-to-date legally and still accurately reflect personal desires.  Having a HCPOA, MHCPOA, and Living Will maximizes a person’s chance of avoiding expensive and time-consuming court involvement, specifically guardianship.

As elder law attorneys, we routinely work with clients in preparing these documents and the Agents acting under them. Medical directives are integral to a complete estate plan. Should you have questions, please call our office at 480-922-1010 or email info@bivenslaw.com to schedule your appointment.