What You Need to Know About Advanced Directives And Home Care

elderly couple with medical power of attorney - advance directive document


elderly couple with medical power of attorney - advance directive document

When your loved one’s independence is fading and you’re concerned about their ability to make sound decisions, you may have legal recourse to ensure their well-being.

The language may vary in your state, but legally speaking, a qualified elder care attorney can help you with advance directive (AD) preparation. Here are some of the terms you may hear during the process:


Advance Directives

There are a number of legal avenues by which someone can have another person step in to make a variety of decisions in the event of incapacitation. Simply stated, advance directives are legal documents stating what you want in the event you’re unable to make decisions about your medical care. This document designates your healthcare proxy, or medical power of attorney (MPOA) to decide on your behalf.


Living Will

A living will may be the most important planning document and should be completed when you are able to make these decisions about your future healthcare. 

“A living will is a legal document that tells doctors how you want to be treated if you cannot make your own decisions about emergency treatment. In a living will, you can say which common medical treatments or care you would want, which ones you would want to avoid, and under which conditions each of your choices applies. 

This is different than a will, which provides legal guidance about a person’s estate — their property and financial assets — as well as care for a child or adult dependents, gifts, and end-of-life arrangements such as a funeral or memorial service and burial or cremation.” 

A living will can be executed only if it’s available to the medical team: keeping it in a lock box won’t help. Be sure to have a copy in your medical record and give a copy to your healthcare proxy, as well. 

The Mayo Clinic has some good advice for how to proceed with your living will.


Power of Attorney 

A legally designated POA has either limited or full authority when a person can’t make their own decisions. As a healthcare proxy, your POA is responsible for your medical care. A Financial POA takes over money and asset management. A Durable POA is someone who manages all aspects of medical, legal, and financial matters. 


It’s important to choose a POA you trust, as it is a serious matter. It is a responsible move because without it, there will be no one to advocate for you and your wishes. Be sure the person is willing and able to perform the duties of MPOA, and that their values align with your own.



In the event that well-being is in jeopardy, a potential guardian or conservator can file with the court.  This is an infringement on their civil  rights, and a serious matter and the process is rigorous. The guardian is appointed by a judge; in New York this type of case is called an Article 81 Guardianship. A guardian can be a friend or family member, or in some cases, an attorney.


The sooner the better

Most people wait until they are elderly and have debilitating health conditions. But the truth of the matter is this: even younger, healthy people can experience medical situations in which they need a decision-maker. Without explicit instructions, the person may receive interventions they don’t want, or they may not get what they do want; they may have a life partner who is denied access to them. There are a lot of variables, so it’s wise to address this before you are unable to.


Horizon Cares

When older adults make the decision to remain at home in their sunset years, it should be specified in their Advanced Directive. Horizon Home Care Services is here to help respect those wishes, as New York Medicaid recipients who qualify for the Consumer-Driven Personal Assistance Program (CDPAP) can receive help to remain in their homes with no out-of-pocket costs.