Q: What is the most common mental health problem among older adults?

A: When a person names a power of attorney (POA) and/or health care surrogate (HCS), they will often choose two people to serve in that capacity. Your mom (the principal) may have chosen to word her advance directives documents to indicate your brother AND you, which would mean you both must act as “co-agents” to make a decision. If worded as your brother OR you, either can be the decision maker. What happens if co-agents cannot agree? This can be tricky and depends on a couple of factors. The first thing that needs to be established is whether the principal has the capacity to make decisions for themselves or not.

If the principal is determined to have sufficient capacity to make their own decisions, then the principal’s wishes will prevail over the agents. To avoid/remedy the situation you cite, the principal may choose to amend their documents and name the single agent they consider most aligned with their own wishes. Or they may simply ask one of the agents to relinquish their role. If the principal is no longer able to make decisions for themselves, then there may be trouble brewing. The hope is that the co-agents will ultimately agree. If they cannot, then the case may need to go to court. This scenario will likely lead to legal fees and could escalate into a battle for legal guardianship.

Often when a principal has completed their advance directives documents and named their POA and HCS, they feel they have “checked that box” –and can move on. The question I always ask clients is, “Have you discussed your wishes with the agents you have appointed?” Ideally, this discussion should occur prior to the preparation of the advance directives. Often their answer is, “Well, I told them that I listed them.” This is when I encourage the client to sit down with the people they have appointed and have a frank discussion about their wishes. It is important (for all involved) that agents agree to honor and implement the principal’s own wishes. A HCS/POA who is not aware of the principal’s wishes can be in a precarious position, as their role may entail end-of-life decisions.

Need more guidance on this important subject? Contact The Experts in Aging at One Senior Place in Viera or Greater Orlando for free advance directives resource materials or a referral to a trusted elder law attorney.


One Senior Place is a marketplace for resources and provider of information, advice, care and on-site services for seniors and their families. Questions for this column are answered by professionals in nursing, social work, care management and in-home care. Send questions to, call 321-751-6771 or visit One Senior Place, The Experts in Aging.

Lisa Conway is a Registered Nurse and a Certified Care Manager for Senior Partner Care Services, Viera.