Ask a Social Worker: Advance Care Planning

Ask a Social Worker: Advance Care Planning

You can appoint someone to make decisions on your behalf when you’re no longer able.

“Ask a Social Worker” is a regular column featuring questions from the community and answers from members of NBDF’s Social Work Working Group. If you have questions for our social workers, send them to [email protected].


Dear Jackie,

Is there a way to appoint someone in advance to make medical or financial decisions on my behalf if I become incapacitated physically or mentally

Although we hope to always remain physically and mentally fit, unexpected life events can happen, and it is best to be prepared. When you turn 18, you become a legal adult in the United States. As an adult, you have the right to choose who can make medical and financial decisions on your behalf if you were ever unable to make these decisions on your own. You also choose what type of medical treatment you would like, or not like, at the end of your life. These are called advance care plans or advance directives.

Power of Attorney

A power of attorney is the most common advance directive for decisions related to finances and health care. A health care power of attorney, also known as a health care proxy, would immediately take effect after a medical event that left you incapable of making your own decisions. That person would talk with your doctors to make medical treatment decisions on your behalf. A person with financial power of attorney can keep paying your bills and act independently regarding your finances when you are not able.

The person you appoint as power of attorney must be 18 or older and of sound mind. This person will be responsible for important financial and medical decisions, so choose someone who understands your concerns. They must be trustworthy, and it helps if you can communicate easily with them. It could be a spouse, parent, adult child, another family member, or a close friend. You can appoint multiple people (such as two adult children) and give them dual power of attorney. In most states, you do not need an attorney to witness or draw up the paperwork (although it’s highly suggested). Each state has different forms and requirements for creating legal documents and, in most states, these will need to be notarized. Of note, a power of attorney is no longer valid after death.

Living Will

In addition to appointing a decision-maker, you can create a living will. A living will outlines your specific treatment preferences for the end of your life. In determining your wishes, think about your values and what measures you would and would not want to be used to keep you alive. Talk to your doctor(s) if you have questions about specific end-of-life medical treatments, such as CPR. 

Some hospitals and medical centers have their own health care representative or living will paperwork that you can complete with a social worker or chaplain, if available. This is different from a health care power of attorney. You can also talk with your hemophilia treatment center about the different options available to you. It is important to plan and prepare for your future.  

— Jacqueline M. Bottacari, LCSW

Bottacari works at the Yale Center for Bleeding and Clotting Disorders and is a member of the Social Work Working Group.