What are the Differences in POA, MED POA, Guardianship, Living Will, Will, and DNR?

Just when you thought you had them all figured out. You’ve come to know and perhaps use dozens of specific acronyms, but along comes a whole new set that the industry you’re inquiring about uses casually, leaving your head spinning. In addition, some of the most often invoked abbreviations come from yet another discipline that has its own mystic language, as well: “Legalese.” You are beginning to get questions answered for yourself or your senior family member and need to determine the differences.

Welcome to “POA,” “MED POA,” “LW,” and a host of others. Take a deep breath and relax. For just a few minutes of your time, Referah will lay out all of the differences and our Family Connection Agents will explain each term so it’s easy to understand.

Breaking Down Legal Terms

These terms, while often confusing, really need to be addressed for any senior or family member caring for a senior. We’ll walk you through a few of the more commonly used terms and why they’re important.

While this review will assist you with planning, it’s important to note that simply having these legal documents in your personal file is not enough. It is critical to place certified copies in a senior’s medical files, including with any medical office they use, and their hospital in case of emergency.

What is “POA”?

“POA” stands for “power of attorney,” which gives one or more persons the power to act on your behalf as the agent of a senior or yourself.

• This could be a limited power that addresses one specific activity. An example is closing on the sale of your residence. However, it can also be more general.
• The defined power may also give temporary or permanent authority to act on your behalf. Additionally, it could become effective immediately after an event or be slated for a future event. The latter is generally centered around the time when a person is no longer able to mentally or physically take action themselves, due to mental or physical disability.
• The occurrence of a future event scenario is referred to as a "springing" power of attorney. POA may be revoked, but most states require written notice of revocation from the person named to act for you.
• The POA should have a senior’s certified copies of medical documentation on hand at all times.
• POA will only go into effect when the person who has entrusted the agent is no longer able to make decisions on their own behalf. Seniors should designate their POA while they have the positive mental capacity and ability to do so.

What is “MED POA?”

“MED POA” is an acronym for “medical power of attorney,” also known as a healthcare power of attorney (HCPA).

• A healthcare power of attorney (HCPA) is defined by a legal document that provides another person with the power to make medical care decisions on their behalf. This classification also references the person as the legal authority and the document itself.
• An HCPA should be a person for which you have full faith and trust. They will be required to take action on your behalf in the case of life or death.
• Follow your specific requirements for MED POA by state. Each has a slightly different set of rules and regulations, meaning you will need to have the correct paperwork in place.
• Just like POA, MED POA will only go into effect when the person who has entrusted the agent is no longer able to make decisions on their own behalf. This is a decision made by a senior when they have a good mental capacity and the ability to make cognitive decisions.

What is Guardianship?

Guardianship is a decision granted by a judge or will where a person is given the responsibility to care for another person (in this case an adult senior). This occurs when a POA is not in place and the person can no longer make decisions for themselves, either mentally (with memory challenges) or physically (such as in an incapacitated state like a coma).

• The appointed individual receives the responsibility of providing care and oversight of the ward’s financial affairs.
• Managing financial affairs is usually called a “conservatorship” and a guardian can also act in this role. Some states like California refer to the two roles as "conservator of the person" and "conservator of the estate." (If you’re a California resident, it’s best to consult a local attorney on this).

What is a Living Will?

An “LW” stands for a “living will” which is a document that details someone’s desires regarding medical treatment in situations where they can no longer provide consent. This is completed by the person while they still have the ability to do so. If the individual has a MED POA, a living will follows that documentation in order to guide decision making. It also allows a medical doctor to review the person’s desires and make decisions based on the individual’s wishes. For example, critical care treatment such as choosing to use or not use a ventilator at a certain level of care type, such as sustaining life while in a coma versus if without brain function.

What is a Will?

A standard will or testament is not medical in nature. Rather, it defines how possessions, assets, and more are distributed after death. It also signifies a person’s final wishes with clear communication to family members.

What is a Do-Not-Resuscitate Order (DNR)?

Different from a living will, a do-not-resuscitate order is a legal form that is signed by both the patient and the doctor in agreement that states no measures, such as cardiopulmonary resuscitation (CPR), will be taken to attempt to resuscitate a person if they stop breathing or to restart their heart if it stops beating. When possible, this document should be agreed upon, prior to an emergency, when a person is still able to actively make decisions on their own. It can follow the selection of a POA where the agent will give directive through wishes defined in a living will.

Additional Legal Guidance for Seniors

Many of the documents used for each of the above scenarios can be obtained online. However, no form is legal and binding unless it’s signed ahead of time and they aren’t retroactive, so don’t use ease-of-access as your family’s personal firewall of protection. And, of course, a call to the family legal counsel is never a bad idea to make sure you have your bases covered.

Can any of these documents online replace an attorney? Should they? Going to an attorney you can take care of all of this at once:

• Legal assistance websites sound great in our instant gratification society and lifestyle, but there’s never as sound an hour of advice as good as sitting with licensed legal counsel who is familiar with state and federal law.
• End-of-life advice from both outside resources and in-house advisors.
• Who is equipped to make sound legal decisions? The best time to make decisions like this is before they’re at a point where they have to be made on the spot. Take time now to talk with family members and determine how those decisions will be made. They might be based on family structure (oldest, most experienced with the situation from past personal episodes, etc.) or proximity to the situation. It’d be very hard for someone to make a clear assessment of a situation for a senior in Sacramento when they’re somewhere on the East Coast.
• Banking decisions and access to accounts are paramount to have in place ahead of time. Having joint access to accounts makes great sense in case after case Referah Family Connection Agents encounter. This is a perfect example of when a limited POA is called for, and a visit to the individual banking institution will provide an excellent first step. Some banks require their own version of POA and may not accept an outside document, so it is best to check with the banking institution regarding their policies. And yes, even though so many banks seem too big and indifferent, you’ll most likely find that they maintain local branch offices and bankers who are more than willing to discuss the topic in detail.
• When is the point achieved where the legal designee (POA, etc.) takes over decision-making power? A doctor makes this certification. This determination can be easy when there is a stroke or no viable communication, but it can be revokable. If a senior family member has a stroke and gets better after medical attention and can communicate, then their POA can return to the senior.

Securing Assistance

Your Referah Family Connection Agent will be a valuable asset for you in making difficult decisions. Not in the capacity of legal counsel, but certainly in giving sound direction as to what’s needed for the situation in question, and how to most efficiently get the professional advice that’s warranted. Our team wants to not only make your decision-making process sound, but also cost-efficient.

Additional resources we recommend for direction include the American Bar Association (www.americanbar.org), Association for Mature American Citizens (www.AMAC.us), the American Association of Retired Persons (www.AARP.org), and your individual state bar association site. These organizations have trusted providers in this arena and won’t guide you to sites or providers whose interests extend beyond the need in question for your senior.

Additionally, Referah can assist you with many other common senior queries from financial to care. For example, you can learn more about making critical real estate choices by viewing our next article “Best Practices for Putting Real Estate on the Market”.

Find Senior Care Near You

When determining important future decisions with your family, it may also be a good time to discuss long term plans for senior living. There are numerous senior living options for older adults in community-based settings that provide care, but also community and a sense of adventure. Talk with a Referah Family Connection Agent to map out a plan for you or your loved one and to find a community that meets your needs.