Please note that some of the following terms, though common, have unique statutory (legal) definitions in healthcare.
Advance Directive (AD) – A legal document (not a medical order) with two parts: a Durable Power of Attorney for Health Care (DPOA-HC, see below) and a Declaration. A DPOA-HC specifies who legally may speak for a patient who cannot express their wishes themselves. The Declaration provides limited instructions for future life-sustaining treatments. Recommended for ALL adults. Click here to complete an Advance Directive online.
Agent – A statutory (legal) term for a Durable Power of Attorney (DPOA). For POLST this is a Durable Power of Attorney for Health Care (DPOA-HC). Also referred to as a representative (see "representative" below)
Durable Power of Attorney for Health Care (DPOA-HC) – Someone who has been legally designated to make decisions for a patient if the patient lacks decisional capacity. This is done through an Advance Directive (available at NVLivingWill.com or your health care provider). A DPOA-HC should be familiar with the patient’s values, their prognosis and willing and able to make decisions in the best interest of the patient.
Healthcare Representative – This term is a legal term as used in the statute governing Nevada POLST. Therefore, in the context of POLST, a representative is only the Durable Power of Attorney for Health Care (also legally termed “agent”), state-appointed guardian or parent of a minor patient.
Healthcare Surrogate – As used with reference to Nevada POLST, a surrogate is a legal term for someone who is authorized to speak for a patient who lacks decisional capacity. The order of such authority is as follows in the following order:
The spouse of the patient
The adult children of a patient
Parents of the patient
Adult siblings of the patient
Other relatives by blood or adoption (no in-laws)
If none of the above are available or willing to speak for the patient, then an adult who has exhibited special care or concern for the patient, is familiar with the values of the patient and is willing and able to make health care decisions in the best interests of the patient, may be an authorized decision-maker.
Authority is granted in the order as listed above. If there is a disagreement between a group (say 4 children who are evenly divided), it does not mean that the next group has authority. It means the disagreeing group needs to come to a majority decision.