In the November 2009 edition of EndNotes, we published a Q&A tailored specifically to assist hospice providers with common decision-making issues related to hospice patients (those with a medical condition that a physician has certified as incurable or irreversible and likely to result in death in a relatively short period of time). No Q&A can exhaust the plethora of unique issues a provider might face in dealing with advance directives made by its patients. The following series of questions and answers is intended to supplement the first series published in November 2009. This edition of EndNotes also includes a workplace poster designed to help your staff understand health care decision-making processes for those patients who cannot make or communicate their own decisions.

Q My patient suffers from memory loss, intermittent confusion and disorientation, and his physician thinks that my patient has not been competent to make or communicate his own health care decisions for some time now. My patient has no power of attorney with health care decision-making powers nor does he have a living will. His wife is deceased, but he has one adult daughter. He also has an elderly girlfriend who sometimes visits and frequently calls him. The girlfriend has just provided me with a copy of a health care power of attorney, naming her as agent to make health care decisions for my patient, but the health care power of attorney was signed by my patient just yesterday. Is this health care power of attorney valid? May the girlfriend make health care decisions for my patient now?