Sorting out
Advance Directives
Important differences exist in advance directives. Only some grant access to another person’s
medical records, and that can change with time.
By Chris Dimick
AFTER 50 YEARS of marriage, Rosa Taylor-Payne noticed even
the slightest change in her husband, Marvell Payne. So she started to worry when he would drive past their destination or forget
the most direct route.
After his memory loss and confusion increased in 2006, Payne
underwent psychological and neurological exams to confirm
what his wife had already noticed. His memory was failing, and
the cause was Alzheimer’s disease.
Concerned for her husband’s health and wanting to help, Taylor-Payne was shocked when she was repeatedly denied access
to his medical information. Federal privacy laws prohibited the
disclosures to Taylor-Payne, even though she was his spouse.
“It made me upset. This is my husband and I’ve been with him
for so many years, but they didn’t give a rat about how long I
had been with him, they just weren’t going to give [the medi-
cal information] to me,” Taylor-Payne says. “It was just frustrat-
ing every time you tried to get information about him, and they
won’t give it to you because of HIPAA law and all this other stuff.
I didn’t care—this is my husband.”
The Paynes soon learned that if Marvell Payne completed a
durable healthcare power of attorney form that designated his
wife as his healthcare agent she could take the active role in
his care they both wanted. The document would allow Taylor-
Payne to sign documents, access and review all of her husband’s
medical information, and help actively manage his treatment.
After consulting a lawyer and drawing up several advance directive documents, Taylor-Payne had no further problems receiving the records to help her husband with his care.
At Best, Frustration...
The Paynes’ experience is not uncommon. For many people, the
first time they hear about the legal requirements for accessing
another person’s records is when they make their first request.
Even determining exactly what legal documents they need can
be a challenge.
Important differences exist in advance directives, the legal
documents that authorize an individual to manage another
person’s healthcare. Different directives serve different purposes and convey different rights, including the right to access the
patient’s medical records.
At best, the confusion results in frustration; at its worst, it can
delay or block access to health records that help manage care.
For patients and their caregivers, it is important to determine
the advance directives they may need well in advance of needing them.
For the HIM professionals in hospitals and other care settings
who receive requests for health records, knowing the rights and
requirements related to advance directives is essential for ensuring that confidential patient information is disclosed only to
authorized persons.
