Lack of a Health Care Proxy Leaves Loved Ones Guessing About Your End-of-Life Wishes

Nearly nine out of 10 upstate New York adults are aware of the term, “health care proxy,” according to a new survey commissioned by Excellus BlueCross BlueShield. Among survey respondents who had heard the term, 89 percent know that it is a way to legally designate someone as your health care agent to represent you during a medical crisis if you can’t speak for yourself.

“Despite high awareness and knowledge of the health care proxy term, our survey also revealed that only about four out of 10 upstate New York adults have completed a health care proxy form,” said Patricia Bomba, M.D., Excellus BCBS vice president and medical director of geriatrics. “That’s disappointing, because so many people have had the experience of making gut-wrenching health care decisions for loved ones who were unable to communicate.”

Excellus BCBS’s online survey regarding end-of-life care was administered by the polling firm One Research. Two-thousand participants completed the survey. A county-level quota sampling method was used to ensure that it would be a representative sample of the region’s U.S. Census Bureau demographic profile.

According to Bomba, a health care proxy can make those decisions easier, and can help people avoid being faced with a situation like the Terri Schiavo case.

In 2005, the nation was transfixed by the family drama surrounding Terri Schiavo, a Florida woman at the center of a legal battle over the right to die. Schiavo was in an irreversible persistent vegetative state as a result of a cardiac arrest. Members of her family had differing views on what she would have wanted with regard to life-sustaining medical interventions. The various factions waged a highly publicized and prolonged series of legal challenges over who had the right to make health care decisions on Schiavo’s behalf.

“When you select a health care agent, ideally it’s a person who knows your values, beliefs and goals for medical care,” said Bomba. “Your health care agent should be able to step into your shoes and choose interventions based on what matters most to you, and not what they would want for themselves.”

Sharing your values, beliefs and goals for medical interventions and completing a health care proxy form are crucial to the advance care planning process. Filling out a health care proxy form legally documents your care wishes, and sharing your wishes ensures that your health care agent and other family members are aware of the proxy and its details. Among those surveyed who had not completed a health care proxy, more than half also had not shared their wishes with family and others.

About a third of survey respondents see the need to fill out a healthy care proxy, but have not successfully completed a form. “Being aware, and understanding the value, of a health care proxy is important,” said Bomba, “but unless you take the time to fill out the form, your wishes may not be carried out.”

Excellus BCBS found that knowledge of the health care proxy is lower in Central New York’s Southern Tier Region (Binghamton and Elmira) than in other parts of upstate New York.

Knowledge of Health Care Proxy, by region

  • Central NY Region - 94 percent
  • Western NY Region - 91 percent
  • Finger Lakes Region - 89 percent
  • Utica/Rome/North Country Region - 84 percent
  • Central NY Southern Tier Region - 79 percent

Age was a factor when it came to knowledge of the “health care proxy” term:  98 percent of respondents age 65 and older reported knowing the term, compared to 61 percent of survey respondents in the 18- to 24-year-old age group. 

“Having a health care proxy gives all parties involved in a medical crisis the peace of mind that comes from knowing the patient’s wishes,” said Bomba. “Everyone who is 18 years old and older should complete a health care proxy form and keep copies on file with their physicians, lawyers and loved ones.”

Other findings from the survey include:

  • Health care proxy awareness and knowledge were significantly higher among women than men.
  • Significantly more men than women feel that they have no need to fill out a health care proxy form.
  • Respondents currently taking a prescription medication for a chronic condition had higher health care proxy awareness, knowledge and completion, compared with those not taking a prescription.

A free step-by-step booklet and discussion guide on advance care planning, including the health care proxy form, are available for download at .

Results of Excellus BCBS’s end-of-life survey establish a benchmark for awareness and completion of the health care proxy among upstate New York adults. View complete survey results online at End-of-Life Care Survey Highlights-A Survey of Upstate NY-Supplement (posted April 2017).


Excellus BlueCross BlueShield, a nonprofit independent licensee of the BlueCross BlueShield Association, is part of a family of companies that finances and delivers vital health care services to about 1.5 million people across upstate New York. Excellus BlueCross BlueShield provides access to high-quality, affordable health coverage, including valuable health-related resources that our members use every day, such as cost-saving prescription drug discounts and wellness tracking tools. To learn more, visit

Source: Excellus BlueCross BlueShield