Patient advocate: Solo agers need healthcare advocates
Approximately 22 million adults 55 or older live alone in America, with an estimated 28% of them being childless. While specific numbers for Illinois are not available, this national statistic gives a general idea of the breadth of the solo-ager population.
When Senior Living News interviewed a selection of solo agers in 2025, it found that more than half hadn’t designated a healthcare advocate or intended to do so. As solo agers are a growing senior demographic, this could leave a lot of people without a safety net should they become unable to advocate for themselves.
Healthcare advocates go by a variety of terms: HCPOA (healthcare power of attorney), POAH (power of attorney for healthcare), healthcare proxy or surrogate decision-maker, but they all mean the same thing: It’s a person you legally designate to make medical decisions for you if you become unable to make them for yourself. For my purposes today, I’ll use POAH.
For people with spouses, children or close-by family, this decision usually isn’t that difficult. For people who are aging alone, miles from family or with no family at all, it becomes a decision that shouldn’t be made on a fly-by-night basis.
Without a POAH, hospitals and doctors lack clear guidance. This often leads to doctors making treatment decisions based on medical standards alone, which may not align with what you actually want. Choosing a POAH in advance makes it more likely that your wishes, values and medical preferences will be respected.
Before I get into how a solo ager can identify a POAH, I want to explain the differences between that and a living will, known in some states as an “advance directive.” Essentially, the POAH designates the “who” and the living will details the “what”: You can say “yes” or “no” to, for example, CPR, resuscitation, intubation or other life-sustaining treatments. You can also designate how long you’d want those treatments to go on before you want them discontinued.
The role of your POAH is not to make the decision they think is best for you, but rather to make the decision you would make for yourself if you could.
That means you want someone you trust, who’s willing to advocate for you, can handle stressful medical situations and can be easily reached. So your POAH doesn’t necessarily have to be geographically nearby, but they need to be within a phone call.
What that person looks like for a solo ager varies.
A private patient advocate: This is usually a board-certified professional with a medical background who understands the situation and whom you trust to act appropriately on your behalf.
A non-family POAH: You can legally appoint someone who is not related to you. Many people choose close friends or neighbors, someone who knows you well and understands your values, or former colleagues who can remain objective in a crisis.
Professional fiduciary: Under a durable power of attorney, a professional fiduciary is an individual entrusted to act as your proxy for either financial matters, health care matters, or both, if you become incapacitated.
Because each of these lacks “next-of-kin” status, it’s important to make your documentation bulletproof, and I suggest working with an elder law attorney to develop them.
Your advance directive should be detailed and specific in your treatment goals. Your POAH should be durable under your state’s requirements. If your healthcare providers use patient portals, make sure your records are complete in order to avoid fragmented care.
What happens if you don’t choose?
If you become incapacitated without a designated POAH and have no next of kin, you are considered “unbefriended” or “unrepresented.” In these cases, decisions are often made by a hospital ethics committee, public guardian or independent physician, who can only act on what they perceive as your wants and values.
To designate a POAH in Illinois, you need to complete a Power of Attorney for Health Care form appointing an agent to make medical decisions on your behalf, and sign the document in front of a qualified witness. This document becomes effective when you are unable to make your own health care decisions. You can find it on the Department of Public Health website, dph.illinois.gov.
By proactively naming a proxy — whether a professional patient advocate, friend or other trusted individual — and carefully documenting your wishes, you maintain control over your health care and ensure your dignity is respected.
• Teri (Dreher) Frykenberg, R.N., a registered nurse and board-certified patient advocate, is the founder of NurseAdvocateEntrepreneur.com, which trains medical professionals to become successful private patient advocates. She is the author of “How to Be a Healthcare Advocate for Yourself & Your Loved Ones” and her new book, “Advocating Well: Strategies for Finding Strength and Understanding in Health Care,” available at Amazon.com. Contact her at Teri@NurseAdvocateEntrepreneur.com to set up a free phone consultation.