When there is no suitable family member to make your health care decisions.
An advance health care directive names someone to make medical decisions when you cannot. Most people name a family member. When no one in the family is suitable, or an estate-planning attorney recommends a professional, FCMS can be considered for the role.
Who it's for.
- People planning ahead who don't have a suitable family member to make health care decisions for them.
- Estate-planning clients whose attorney recommends a professional.
- A parent's advance health care directive named an adult child who lives across the country, and the family wants a local professional to be the immediate decision-maker — with the out-of-state child consulted but not the one fielding calls from the hospital.
- A parent has had a memory diagnosis in the last few months. Capacity is still there for now, but the family wants to set up powers of attorney, identify who will be the trusted agent for finances and for healthcare, and review the trust before the window closes.
How an appointment is considered.
FCMS considers professional health care-agent appointments individually. Before accepting an appointment, we discuss the client's wishes, the responsibilities involved, compensation arrangements, and coordination with other authorized decision-makers. Appointments are established through appropriate legal documentation. A Future Care Continuity Plan does not automatically create or guarantee a fiduciary appointment.
What the role involves.
The document. The role is created by an advance health care directive. We read the document carefully before we accept the role. The document defines our authority — broader or narrower as drafted — and our obligations.
When the authority begins. A health care agent's authority begins when the directive says it does — California's statutory form lets the principal choose immediate effect or effect only on incapacity. We confirm what the directive provides, and that the conditions for acting have been met, before we begin.
The ongoing role. Knowing the principal's wishes from their AHCD and from prior conversations. Being reachable. Making medical decisions in coordination with the treating physicians — not in opposition to them. Knowing when to consent to treatment, when to consent to hospice, when to honor a POLST. At the principal's death the role narrows to the few matters the directive and California law still assign to the agent — organ donation, authorizing an autopsy, and the disposition of remains — and nothing beyond that.
A way to prepare.
A Future Care Continuity Plan helps the people you name understand your wishes and organize important information before they are needed.
Common questions.
Why would I name a professional instead of a family member?
Most families do name a family member, and that is often the right answer. A professional becomes the right answer when no family member is willing or available, when the family is in conflict and a neutral is needed, when the principal lives alone with no nearby family, or when the principal does not want the person they love to be the person making clinical decisions about them in a crisis. The conversation is worth having before the documents are signed, not after.
Can the family member stay involved if a professional is the agent?
Yes. Within the authority the directive gives, the agent decides, but a good agent consults — family, treating physicians, the principal's attorney. We are not a wall around the principal; we are a professional running point. An engagement can include a regular check-in call with an adult child who wants to know what is happening but does not want to be the one making the calls.
How do we know whether a parent still has capacity to sign documents?
California measures capacity decision-by-decision, not as a global on-off state. The legal standard for executing a power of attorney is generally that the principal understands the nature and consequences of the document. Where capacity is in question, an evaluation by a neuropsychologist or a physician familiar with capacity assessment gives a defensible record. We can help arrange that.
Planning for yourself, with no spouse or children to step in? Our guide to planning ahead as a solo ager in California covers who can hold the key roles and why lining them up early matters.
If you are simply trying to understand the document itself, our guide to what a power of attorney is in California covers financial versus health-care authority and what an agent can and cannot do.
How working with FCMS begins.
- Initial consultation and assessment of the proposed role.
- Review of authority, documents, and engagement requirements.
- Formal acceptance and commencement of responsibilities.
- Ongoing administration, communication, documentation, and reporting as required by the appointment.
Consultations are by appointment and held in strict confidence.
Or call 760-33-TRUST (760-338-7878) directly.
Discretion and confidentiality are fundamental to our practice. Information submitted through this form is kept private and used solely for purposes of communication regarding potential fiduciary services.
