Growing older comes with its share of joys and challenges. Among the latter is failing health.  

Illness can be all-consuming, making it difficult to speak for yourself and take control of your medical care. That’s where a trusted healthcare proxy comes in.  

They become your voice and they ensure your end-of-life care intentions are met.  

What is a healthcare proxy?  

A healthcare proxy is an important part of creating advance directives. These are the formalized instructions outlining your wishes for end-of-life care.  

Your healthcare proxy is the person who will make decisions for you, following the instructions you outline. To create advance directives and appoint a healthcare proxy, you need to be of sound mind.  

That’s why it’s essential to think and plan ahead, creating proper documentation before your health worsens. Your doctor decides when you’re no longer considered capable of making decisions yourself.  

Below, we outline varying guidelines around appointing a healthcare proxy in Canada and the United States.  


A healthcare proxy is identified in your healthcare directives, or advance directives. This document outlines your wishes - and who you appoint to carry them out for you.  

In Canada, healthcare directives don’t necessarily need to be legal documents. Although, that does help to formalize and organize them. You can write a handwritten note, as long as it is dated and signed.  

United States 

Policies can vary from state-to-state, though every state permits individuals to express their wishes in the case of terminal illness or injury while appointing someone to carry out those wishes for you.  

The terminology is what varies the most, as well as how  wishes are documented. They can be referred to as "living wills," "medical directives," "health care proxies," or "advance health care directives." 

Depending on where you live, confirm if you’re able to use your own document or if there are standard forms you need to fill out. Always ensure you read everything thoroughly and properly document your wishes before signing anything. Healthcare proxies, depending on the situation, may also be responsible for applying for insurance programs or other medical benefit programs on someone’s behalf.  

What does a healthcare proxy do?  

A healthcare proxy makes end-of-life care and healthcare decisions for you when you’re no longer able. Often, they will be provided with your advance directives outlining your wishes.   

These kinds of decisions can include things like:  

  • Implementing a Do Not Resuscitate order or other orders to prolong life. 
  • Opting for hospice care.  
  • Facility selection, such as the decision to move to another hospital.   
  • Increasing or decreasing pain management medication at end-of-life.  
  • Specific guidelines around medical care relating to specific conditions.  
  • Guidelines around comfort and care.  

In some cases, a healthcare proxy may not know your exact wishes. This is why it’s important to appoint someone who knows you best and someone you may have spoken to on this topic - even if nothing is in writing.  

How to choose the right healthcare proxy for you  

First and foremost, your healthcare proxy needs to be someone you trust.  

Next, ensure it is someone who is able to properly fulfill your wishes. That means choosing someone who is in good health, of sound mind and has a history of responsible decision making.  

It is ideal to pick someone who is nearby and won’t require long-distance travel to reach you. Often, end-of-life care can take days, weeks - or even months. Your healthcare proxy needs to be able to spend extended periods of time in the hospital or medical facility.  

Lastly, choose someone who is able to be your advocate.  

They need to be able to express your wishes clearly and directly to the medical team, even when situations are emotional and stressful.  

Your medical team will make the call as to when a healthcare proxy takes over. That’s when their duties kick in. To help prepare them, talk to them in detail about your plans for your healthcare and your wishes for end-of-life. Ensure they have detailed information about your condition so they properly understand things like pain management and comfort care.  

Advantages of choosing a healthcare proxy   

Choosing a healthcare proxy gives you a degree of control - even when you are no longer able to make decisions for yourself.  

Assigning a trusted person to carry out your wishes for your health can give you the peace of mind you need as you transition into worsening stages of health and aging.  

Here are the advantages:  

  • You have some direction in planning for your healthcare. You set the direction while you’re still able and of sound mind.  
  • You have a trusted person who is there to act in your best interest. 
  • Appointing a healthcare proxy alleviates family stress during an already difficult time. Assigning a person who takes responsibility ensures health care planning isn’t spread across multiple people and important details aren’t lost in the shuffle.  

What if I’m a healthcare proxy?  

If you are appointed someone’s healthcare proxy, your primary responsibility is to ensure all healthcare-related end-of-life wishes are fulfilled.  

You need to be assertive and direct - capable of communicating responsibly with a team of medical professionals. You should also be organized, ensuring you have a copy of healthcare directives and the medical team is given the same document.  

In an ideal scenario, you will have had lengthy conversations with the person who appointed you to understand their wishes, their medical history and the nuances of their healthcare team.  

Most importantly, you’re acting on someone else’s behalf based on their wishes. That means putting your personal opinions aside.  

As a healthcare proxy, you’re not responsible for other parts of the end-of-life process, like executing a will, unless otherwise appointed to do so.  

What if I change my mind?  

Once you assign a proxy, you do still have the flexibility to change your mind about your healthcare directives.  

The most important thing is documentation and updating your directives on paper. Ideally, you will create both digital and physical copies - dated and labelled with the most current version.  

Ensure your healthcare proxy and medical team are given the most recent copy of your directives.  

Facing end-of-life is never easy. But, the knowledge you have a trusted voice to speak for you can do wonders for your peace of mind.