It's an important question: If you don't have relatives or close friends who can serve as your health care proxy or hold your power of attorney (which in most states involve two separate documents) are you supposed to resign yourself to whatever the emergency room physician or intensive care staff member decides to do, or not do, when you can't direct your own care?
Truly, it is a blessing to have a family to share life with you. That fact is no clearer should the time come to make life-and-death health decisions on your behalf. But what if you have no "family" to name as your healthcare proxy or as the agent on your power of attorney?
The New Old Age blog of The New York Times recently took up the question of "When There's No Family."
This is an especially difficult problem for many seniors. They oftentimes need someone to wield a power of attorney and even a medical directive to go to bat in their interests with medical staff, not to mention settling aspects of the estate. While there are close friends for many seniors even in lieu of family, it is still not uncommon to be without even these.
According to the American Bar Association's Commission on Law and Aging, "perhaps 4 percent of older adults are 'the unbefriended elderly,' a chilling phrase referring to those who cannot make decisions for themselves, have no advance directive or surrogate decision maker, and have no family or friends able to assist."
Unfortunately, there are few easy solutions. Even engaging a professional to serve in such capacities can be a difficult road, too. The professional will be bound to certain standards and difficult legal requirements. In addition, not everyone can serve in this capacity, especially the medical staff an elderly person may have come to befriend and rely upon.
Fortunately, solutions are emerging -- like the notion of a "care community" of elderly individuals looking after one another, financially, medically and often legally.
Whether such a solution is open to you, it is still absolutely vital to have robust advanced directives concerning end-of-life decisions. Make sure you have appointed someone you know and trust to speak for you and do for you when you cannot. The importance of having your end-of-life wishes committed to writing cannot be overemphasized.