Medication Decision Guide
This tool helps you think through key medication decisions so you can communicate your wishes clearly to your healthcare proxy. Answer each scenario honestly to prepare for important conversations.
Scenario 1: Severe Infection
You have a severe bacterial infection and are too weak to eat or drink. Your doctor suggests IV antibiotics to fight the infection. Your kidneys are failing. You're in significant pain.
Scenario 2: Pain Management
You're in significant pain from your condition. Your doctor suggests strong pain medication like morphine that might cause drowsiness and reduce alertness. This could help you sleep better but might shorten your life by a few days.
Scenario 3: Blood Thinners
You're taking blood thinners to prevent clots, but you've had a minor injury that could cause bleeding. The risks of stopping the medication are high, but the side effects of continuing could be serious.
Scenario 4: Dementia Agitation
You have advanced dementia and become very agitated at night, screaming and hitting others. Your doctor suggests antipsychotic medication that might calm you but could also cause sedation and cognitive issues.
Scenario 5: Feeding Tubes
You're unable to eat or drink due to your condition. Your doctor suggests a feeding tube to provide nutrition, but it could cause discomfort, infections, and doesn't necessarily improve your quality of life.
Your Medication Preferences
Based on your selections, here's what you might want to communicate to your healthcare proxy:
- For severe infections: You'd want antibiotics if they improve your quality of life and pain management
- For pain management: You're open to strong pain medication if it doesn't significantly impair your alertness
- For blood thinners: You prefer to balance bleeding risk with clot prevention
- For dementia agitation: You'd try non-medication approaches first
- For feeding tubes: You'd focus on comfort care only
Key steps to take:
- Share these preferences directly with your healthcare proxy
- Update your Medical Power of Attorney to include these specific instructions
- Have regular check-ins with your proxy to ensure they understand your values
- Consider including this summary in your advance care plan
Imagine you’re in the hospital, unable to speak. Your heart is failing. Your kidneys are shutting down. The doctors ask your family: Should we give her this antibiotic? What about pain meds? Should we stop feeding her through a tube? No one knows what you’d want. Siblings argue. Nurses wait. Hours slip away. This isn’t fiction. It happens every day. And it doesn’t have to.
What Is a Medical Power of Attorney?
A Medical Power of Attorney (also called a Healthcare Proxy or Durable Power of Attorney for Health Care) is a legal paper that lets you pick someone you trust to make medical decisions for you if you can’t speak for yourself. It doesn’t kick in while you’re alert and able to talk. It only activates when you’re unconscious, in a coma, or too sick to understand what’s happening. This isn’t about giving up control. It’s about keeping it-even when you can’t speak. All 50 states recognize this document. But rules vary. In California, your signature alone is enough. In New York, you need two witnesses who aren’t relatives or beneficiaries. Indiana requires your doctor to sign off if it involves psychiatric care. The key? It must be signed while you’re still mentally clear. Once you lose capacity, it’s too late.Why Medication Decisions Are the Most Critical Part
Most people think advance directives are about machines-ventilators, feeding tubes, CPR. But the real daily battle happens with medication. Your agent can decide:- Whether to give antibiotics for a severe infection
- Whether to use strong painkillers like morphine, even if they might shorten life slightly
- Whether to stop blood thinners that could cause bleeding
- Whether to give antipsychotics for agitation in dementia
- Whether to allow injections instead of pills if you can’t swallow
Living Will vs. Medical Power of Attorney: What’s the Difference?
You’ve probably heard of a living will. It’s a document where you list what treatments you want or don’t want. Like: “No CPR if my heart stops.” “No feeding tube if I’m in a permanent coma.” But here’s the problem: life doesn’t come in neat boxes. What if you get a rare infection that responds to one drug but not another? What if your dementia gets worse, and you’re screaming in pain-but the living will doesn’t mention pain meds? That’s where the Medical Power of Attorney wins. Your agent can make decisions on the fly. They can read the doctor’s notes. They can ask questions. They can weigh risks and benefits in real time. A living will gives instructions. A healthcare proxy gives judgment. The Mayo Clinic says it best: “A living will doesn’t cover every situation.” That’s why most experts recommend having both.POLST: The Missing Link for Serious Illness
If you’re already dealing with a serious illness-cancer, advanced heart failure, late-stage dementia-you need something more than a proxy. Enter POLST (Physician Orders for Life-Sustaining Treatment). It’s not a substitute. It’s a supplement. POLST is a medical order, signed by a doctor, that tells EMS, hospitals, and nursing homes exactly what to do. It covers:- Whether to resuscitate
- Whether to use a ventilator
- Whether to give IV fluids
- Whether to use antibiotics
- Whether to provide artificial nutrition
How to Choose the Right Agent
This isn’t about who’s the oldest child. Or who’s the most responsible. Or who’s the easiest to get along with. It’s about who understands your values. Ask yourself:- Would they honor your wish to avoid suffering, even if it means a shorter life?
- Would they stand up to doctors who push for “everything possible”?
- Would they say no to a treatment you’d hate-even if your family pressures them?
What to Say to Your Agent (The Real Conversation)
Don’t just hand them the form. Have a real talk. Sit down. No distractions. Ask:- “If I had a stroke and couldn’t move or talk, would you want me kept alive with a feeding tube?”
- “If I had dementia and forgot who you were, and I was screaming all night, would you want me on drugs to calm me-even if they made me sleepy all day?”
- “If I got pneumonia and I was 90, would you want me in the hospital for IV antibiotics, or would you let me stay home and be comfortable?”
- “What’s the worst thing you can imagine for me?”
Where to Get the Form (For Free)
You don’t need a lawyer. You don’t need to pay. Every state has free, legally valid forms online:- LawHelp DC - Offers state-specific templates
- Indiana Health Care Quality Resource Center - Clear, simple forms with instructions
- American Bar Association - Updated 2023 multi-state form
What to Do After You Sign
Signing is just step one. Here’s what to do next:- Give a copy to your agent
- Give a copy to your primary doctor
- Give a copy to your hospital’s medical records department
- Put a copy in your wallet or phone under “Medical Info”
- Tell your family where to find it
What Can Go Wrong (And How to Avoid It)
Here are the top three mistakes people make:- Not talking to the agent - 41% of agents admit they’re unsure what their loved one really wanted.
- Choosing the wrong person - Picking the oldest child because “it’s tradition,” not because they understand your values.
- Forgetting to update - Your agent died. You got divorced. You changed your mind. But the form hasn’t been touched since 2015.
Technology Can Help-But Not Replace
There are apps now that help you plan. PREPARE (free, from UCSF) uses short video scenarios to walk you through tough choices. You answer questions like: “Would you want to be on a ventilator if you could never speak again?” A 2022 study found people using PREPARE were 43% more likely to complete their forms than those using paper. But here’s the truth: no app can replace a conversation. No algorithm can know your fear of being trapped in a body that won’t move. No AI can hear the quiet tone in your voice when you say, “I don’t want to be a burden.” Technology helps you prepare. But only you can decide.Why This Matters More Than Ever
Every day, 10,000 Americans turn 65. By 2030, 1 in 5 people will be over 65. Most will face dementia, heart failure, or cancer. And most will lose the ability to speak for themselves. Right now, only 36.7% of U.S. adults have any advance directive. That means two out of three people are leaving their medical fate to chance-or to family fights. This isn’t about death. It’s about dignity. It’s about control. It’s about making sure the last days of your life reflect your values-not someone else’s fear, guilt, or ignorance. Your agent isn’t just a backup plan. They’re your voice when you can’t speak.Start Today. Not Tomorrow.
You don’t need to be old. You don’t need to be sick. You just need to care enough to act. Download your state’s form. Pick your agent. Have the talk. Sign it. Share it. It takes 30 minutes. But it can save years of pain-for you, and for them.Can my agent override my living will?
No. Your agent must follow your written wishes in your living will. But if your living will doesn’t cover a specific situation-like a new medication or unexpected complication-your agent can make a decision based on what they know about your values. The living will sets boundaries. The agent fills in the gaps.
What if my family disagrees with my agent’s decision?
Legally, your agent has the final say-if the document is valid and properly signed. Hospitals can’t override it unless there’s evidence of fraud or abuse. But family conflict is common. That’s why clear conversations and written instructions are so important. If your agent knows your wishes and can explain them calmly, it reduces chaos.
Can I change my agent after I sign the form?
Yes. You can revoke or change your Medical Power of Attorney at any time, as long as you’re mentally capable. Just sign a new form, destroy the old one, and tell everyone who had a copy.
Do I need a lawyer to make a Medical Power of Attorney?
No. All 50 states offer free, legally valid forms online. A lawyer isn’t required unless your situation is complex-like owning a business, having multiple families, or living in multiple states. For most people, the free form works perfectly.
What if my agent is not available when I need them?
When you sign your form, you can name a backup agent. If your first agent can’t act-because they’re out of town, sick, or unwilling-the backup steps in. Always name one. Don’t leave it to chance.