Your Teen Turns 18: The Medical Paperwork Parents Need

Hi, friends. Next week the last of the "kids" in our country household turns 18, and today I want to talk about unsexy topics like the health care power of attorney (Vorsorgevollmacht) and the patient directive (Patientenverfügung, similar to a living will). I honestly didn't understand any of it myself, and I'd like to take you along on what I've learned. To protect you and your kids!

First, though: don't think that once you've gotten one kid through this particular birthday, the emotions get easier. I'd even say that when your last kid turns 18, it hits EVEN harder, because now you really have ALL of your kids as legal adults.

Your kid is 18! As a parent, you're out at the bank and the health insurance company

With my oldest, I was still surprised when, a few days after her 18th birthday, her health insurance company wouldn't give me any information over the phone (she was abroad and her university needed a document, but no, without a power of attorney I wasn't allowed to take care of that for her anymore), and I got kicked out of all of her banking apps. So at least I knew about that part this time.

Still, you get smarter and wiser over the years, and at some point I picked up that if we don't take care of certain paperwork, we'd also be shut out after an accident. If one of our kids fell into a coma after turning 18 and ended up in a hospital, parents without a power of attorney and a patient directive might not be allowed in to see them!

In an emergency: hospitals may not give parents of adults any information

Of course, in a way that makes sense. Maybe parents and child are fighting, aren't in touch anymore, or something else stands between them… But what about everyone else?

When my son recently had a mild concussion after a head collision on the soccer field, the only thing that really helped was me lying down next to him with a book. Sheer presence can sometimes work healing miracles. So I'm assuming my kids would like it if we, their parents, could keep standing by them in case of a more serious illness.

And hey, I'm thinking of ME too. I'd like to be there, thank you very much, if something happens. Not standing in front of closed doors. I don't want to spread panic, and I think in most cases parents are let in to see their sick child, but legally speaking, hospitals don't have to allow it. So honestly, I'd rather sort this out ahead of time and have some peace of mind.

At 18: power of attorney and patient directive

Here are the facts. In Germany, starting on their 18th birthday, we parents no longer have legal authority to act for our kids, and so no automatic right to information either, not even in a medical emergency. To stay able to act in case of an accident or cardiac arrest or whatever else, we need two documents: a power of attorney for health care and a patient directive.

The power of attorney allows you to make decisions on your child's behalf when, for example, they're unconscious. Important for the hospital: the power of attorney has to cover health care. Only then will doctors give you information, let you see the medical records, and let you consent to medical treatment—or refuse it.

To actually get information from the doctors about your child's condition in the ICU, you should add an extra clause to the power of attorney releasing the doctors from patient confidentiality (you can also have a separate one signed).

Where to find the forms

Where do you get a form like that? You can just google it. The German Federal Ministry of Justice, for example, offers a free download, the BMJ form for the power of attorney, which already includes the release from confidentiality (under Health/Care Needs).

In the additional patient directive, your child states in writing which medical procedures, treatments, or life-sustaining measures they do and don't consent to in certain situations, for example if they fall into a coma. (If you're feeling unsure about the medical questions, by the way, you can get advice from your family doctor.)

The document is addressed directly to the doctors, but of course it can also be an important guide for you. If the power of attorney gives you the authority to decide, you'll want to act in your child's interest, too. Makes sense, right? You can look through all the info, for example, on the Ministry of Justice's page on the patient directive.

You can also fill out both the power of attorney and the patient directive step by step through the online service of the German consumer advice centers. It's free, and afterward you can print it out at home, legally sound. The Malteser aid organization also offers a great, accessible online assistant for patient directives that's based on the legal requirements. Take a look and see what fits you best.

Do you need a notary?

What matters is that your child signs the papers voluntarily, is an adult, and is of "sound mind." It has to be in writing, with place and date, and your child has to sign it by hand.

You can of course have it all notarized, which surely increases acceptance, but we're skipping that and relying on the papers our kids sign themselves. No need to overdo it. Print it twice, one copy for your child, one for you. Then you're at least a little bit covered, just in case.

You can also register with the Central Register of Advance Directives (Zentrales Vorsorgeregister, or ZVR) of the German Federal Chamber of Notaries, which can be accessed electronically around the clock. In other words, if your child can't speak for themselves, hospital staff type in the name and immediately see: "There is a power of attorney for the mother."

Filling out the online application on the ZVR's registration page for private individuals takes only about 5 minutes. It costs a bit more than 20 euros, one time. The registration doesn't replace the actual document, though. If you don't want to go to a notary, you can also turn to the guardianship authority in your city or town. They offer advice and documents too, and certification apparently costs only around 10 euros if you'd like a stamp. Like I said, it's not strictly necessary.

Important: none of this is a one-way street. If something should happen to you, you can also decide who gets to receive information. Your kids don't automatically get information or get to make decisions if something happens to you, either. So you can cover each other.

Personally, we're starting simple, with a few sheets of paper. And you do it however you feel most comfortable! I hope I could bring you along a bit and that you won't have to search as long for everything as I did. Here's hoping the day never comes when we'd need any of this. That's my wish for all of us!