Question: My husband and I live in the Northeast and have traveled the country in our motor home since we retired in 2001. We pretty much stay in contact with our children by cell phone because we seldom have an itinerary when we head out.

At the suggestion of our lawyer, we carry copies of our recorded powers of attorney and our health care directives with us, just in case. We keep them with our vehicle registration. Over the years, we have added various provisions to our health directives in our own handwriting. We did not believe our family would have any problem using these until we read recently that our health care documents might not be valid in other states. 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. 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.

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 that would actually be made if that individual faced an imminent life-threatening illness at the time of the decision. In other words, some health care providers, such as banks, may impose a self-constructed “staleness doctrine” to judge your documents.

It would be impractical and ridiculous for your first stop in every state to be a lawyer’s office where you could sign the state-specific form for that state. It would be just as ridiculous to be required to find the specific health directive forms for each state and sign them on your own.

Since you have written your directives and signed them in accordance with the law of your state of residence, those forms and your handwritten additions should be enforceable wherever you may be as expressions of your intentions. Make sure your children have copies of your health documents and instructions, however, to ensure that your wishes are followed.

Question: I feel that my father’s medical records have been compromised by the staff of the hospital where he is a patient. While visiting last week, I walked by the nurses’ station and overheard a nurse talking openly and loudly to others about my father’s condition, including his lack of bowel movements and his possible dementia. Some were joking about his calling one of them his wife. The nurses’ station is in the center of the ward, and anyone walking by or in many of the rooms could hear the nurses. I feel that his right to privacy has been compromised, and I’d like to know how to deal with this.

Answer: While private discussions in an in-patient setting may be difficult to manage, we believe that you have cause for concern. Each patient or facility resident has a right to privacy with regard to his/her personal and clinical records. By law, your father’s records must be kept confidential. Staff discussions about his medical condition should take place in a manner that does not compromise the duty of confidentiality. And idle chit-chat and jokes about patients in earshot of other patients and family members have no place in a health care facility. While we realize that staff members are very busy and that the job is hectic, public discussions such as you have described are inexcusable, and should be reported to the facility administrator.