Advance Directives

• Financial Power of Attorney – This document, completed before the person loses capacity, allows them to appoint someone to act on their behalf in financial matters should they lose capacity.
• Health Care Advance Directive – This may be a living will, health care power of attorney, or a single document containing both. These documents need to be completed when the person has capacity to understand them and make the necessary decisions about their own future care.
• oLiving will give instructions for making medical decisions regarding end-of-life care.
• oA health care power of attorney appoints someone to make medical and end-of-life decisions on the person's behalf.vi
• Physician Order for Life Sustaining Treatment (POLST) – This document can be created by a doctor to communicate a patient's condition, preferences, and end-of-life medical care decisions when that patient has a terminal illness. If a patient decides to create a POLST with their doctor's help, the form then stays with the patient in case they need emergency care or become incapacitated.
• Mental health power of attorney – This document, authorized under Pennsylvania law, permits a person with a mental illness to provide instructions in advance regarding the treatments and medications to which the person would consent if able, and may name an agent to act when the person is not able to make decisions himself or herself.

Health Care Representative

When a doctor determines that someone does not have capacity to make their own medical decisions and that person does not have a guardian or agent identified in a health care power of attorney, a health care representative can make certain medical decisions on the person’s behalf like a guardian of the person. When determining who may act as health care representative, priority is given to spouses, adult children, and other close family members. While the doctor may have the representative sign a declaration, the court, generally, is not involved with this process.ix

Supportive Relationships, Community Services, and Residential Settings

An individual may be able to avoid guardianship if they have supportive family, friends, and others who can help them with certain tasks that they are not capable of doing on their own.

There may be services available in the community that can help the individual maintain independence to the extent possible. These services could include meal preparation or delivery, house cleaning, personal care assistance, adult day programs, and more.

Certain residential settings may provide a supportive environment and certain assistance that will allow the person to live independently while getting necessary support.