Being family isn't the same as being able to help

With a nod to Roz Chast, who drew the talk families keep postponing. It is worth having when young, and worth having now.

Photo by SHVETS production

Your child turns 18 and something quiet happens that no one mentions at the graduation party. In the eyes of the law, you stop being their decision maker. Not because anything changed between you. Because they became an adult, and adults make their own medical and financial choices.

Most of the time, that is exactly as it should be. The question is what happens on the day they can't. A bad accident. A sudden illness. A moment where your once-small child is in a hospital bed, unable to speak for themselves, and a doctor needs someone to make a call.

Here is the part most families never learn until they are living it. In a lot of places, the people who love you most have no automatic right to step in.

There is a common belief that "next of kin" carries legal weight, that a spouse or a parent can simply make the decision. In some states that is broadly true. Most states have what are called default surrogate, or family consent, laws, which set out an order of family members who can decide when no other document exists. But a handful of states do not, and even where these laws exist, they are a fallback, not a plan. They apply only when nothing better has been put in place.

Wisconsin, where I live, is one of the clearest examples. A State Bar of Wisconsin column is direct about it: here, next of kin have no automatic authority to make health care decisions. Not a spouse. Not a parent. Not an adult child. Without the right document, families can end up in court just to earn the standing to help someone they love.

And it is not your home state that decides this in the moment. It is the state where care is happening. If your daughter is hospitalized two states away at college, the hospital there handles the decision under its own rules. The reassuring part: a properly signed health care power of attorney travels with her, recognized across state lines. Which is exactly why it is worth having before she leaves, not after something happens.

The fix is smaller than the fear. It is one conversation and a few documents. A health care power of attorney names the person who can make medical decisions if you cannot. A HIPAA authorization lets a doctor actually talk to them. A durable power of attorney covers finances. For an 18 year old heading to a dorm, and for a parent in their 80s on the other side of the world, the documents are the same. The act of care is the same.

It helps to say plainly what one of these documents does not do, because the phrase "power of attorney" scares people into delay, and delay is the only real risk here. A health care power of attorney does not hand your decisions away the day you sign it. It sits quietly. It takes effect only when a physician certifies that you cannot make decisions for yourself. Until that moment, you remain fully in charge of your own life. That is the whole reason an 18 year old can sign one without giving anything up. And the same is true for a healthy, fully independent parent in their 80s. Signing one changes nothing about the life they are living. It simply means that if a day ever comes when they cannot speak for themselves, someone they chose already can.

I think about this in two directions at once. My kids, not far from the age where the law stops seeing them as mine to protect. My parents, in their 80s, halfway around the world. All aging. All far away. All easier to help with one signature than with a court order.

Signing the documents is the first step. Knowing who holds them, where they live, and who to call at 2am is the next one, and it is the part families almost always miss. That coordination, carrying the right information to the right person at the moment it matters, is the work we do at CuroNow. Inside the app there is a vault for exactly this. You can upload the signed document, or, if you would rather keep the original in a drawer at home, simply note that it exists and where to find it. Either way, no one is hunting for it during a crisis. But the document comes first, and it does not require us, or anyone. It requires an afternoon.

So this is the ask, said with care rather than alarm. Get the powers of attorney signed. For yourself. For your college kid. For your aging parents. Not because something will go wrong, but because the people who love you should never have to ask a court for permission to help you.