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Health Care POA in different states & does staff chit-chat violate privacy

Question: Since we retired and purchased our motor home three years ago, my wife and I travel and spend a lot of time in several different states. We give our children our itinerary when we leave and take our cell phone to make sure we can remain in contact. We also carry in our glove compartment our powers of attorney and health care powers of attorney from our state of residence, just in case. But we read recently that we might have problems with our health care documents being valid in another state. Is this true? And if so, how can we make sure we are protected?

Answer: Because each state legislature regulates its own documents, there is a lack of uniformity from state to state regarding health care powers of attorney and living wills. While the majority of state laws provide that out-of-state documents are valid to the extent they comply with local law, forms and procedural requirements differ from state to state. And, in some instances, the kinds of medical decisions that can be delegated to the agent may be limited despite the clear expressed intent of the principal. The best solution to this confusing mess for travelers like yourselves is to prepare and sign health care documents that comply with the law of the states where you spend the most time. So long as you and your wife understand the options and procedural requirements for signing, you can pick up copies of these documents in each state.

To further complicate matters, some health care providers have become apprehensive about the possible differences in the choices made by a competent person well in advance of a serious illness and the choices which would actually be made if that individual faced an imminent life-threatening illness at the time of the decision. To alleviate this potential problem, assuming your choices have not changed, it would be a good idea to attach a dated memorandum to your health care documents every two years or so to confirm your choices. If you change your minds, you should sign new documents.

Question: I have been concerned about the disclosure of information from my mother's medical records at the nursing facility where she is currently a resident. Her room is near the nursing station and, while I was visiting last week, I was shocked to overhear a nurse and an aide talking about my mother's lack of progress and what they referred to as the "sourpuss" disposition of my mother's roommate. My mother and her roommate may be ill, but they both can hear. And so can everyone else within earshot. Does this not breach my mother's right to privacy, and how should I handle this?

Answer: You have cause for concern. Each resident has a right to privacy with regard to his or her personal and clinical records and the right to have those records kept confidential. Discussions about medical conditions by staff should take place in a manner that does not breach the duty of confidentiality. To us, this means that chit-chat about patients in earshot of other patients and family members is inappropriate. While we realize that staff members are very busy, the public discussions as you describe are inexcusable. We suggest that you air your concerns to the administrator who, we are sure, will take remedial action.

NextWeek in NextSteps: Due to a large number of reader requests for information about the use of chemical and physical restraints in nursing facilities, we will answer your questions about this somewhat controversial topic next week.

Need more advice or help with this topic? Click here to get information about taking the "Next Step".

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