Medical Power of Attorney Arkansas: Healthcare Agent Rules for Aging Parents

The hospital calls to say your parent was admitted after a fall, and the attending physician needs consent for surgery. You show up ready to make decisions — but the admissions desk tells you that without a medical power of attorney on file, they cannot accept your authorization.

In Arkansas, a medical power of attorney — formally called a Durable Power of Attorney for Health Care — is part of the state's Advance Care Plan. It designates a specific person (the "healthcare agent") to make medical decisions when your parent cannot communicate or lacks the capacity to decide.

What a Healthcare Agent Can and Cannot Do

Under Arkansas Code § 20-6-103, a healthcare agent has authority to:

• Consent to or refuse medical treatments, surgeries, and medications
• Choose hospitals, rehabilitation facilities, and long-term care placements
• Access medical records and communicate directly with physicians
• Make decisions about experimental treatments or clinical trials

A healthcare agent cannot manage financial accounts, sign contracts, sell property, or interact with government agencies about benefits. Those powers require a separate durable financial power of attorney under Arkansas Code Title 28, Chapter 68.

Signing Requirements

The healthcare POA must be:

• In writing and signed by the parent (the principal)
• Either notarized OR witnessed by two competent adults

If using witnesses instead of a notary, Arkansas law imposes specific restrictions:

• The first witness cannot be the person named as healthcare agent
• The second witness cannot be the agent, cannot be related to the parent by blood, marriage, or adoption, and must not be entitled to any portion of the parent's estate under an existing will

These restrictions exist to prevent conflicts of interest. A notarized document avoids the witness eligibility question entirely and tends to be accepted more readily by hospitals.

When the Authority Activates

Under the default rule in § 20-6-103(d), the healthcare agent's decision-making authority takes effect only after a licensed physician formally determines that the parent lacks capacity to make their own medical decisions.

Your parent can change this default. The document can specify that the agent's authority begins immediately upon signing — useful if the parent wants the agent to coordinate care while they are still competent but physically unable to manage appointments and communications.

Choosing the Right Agent

The healthcare agent should be someone who:

• Lives close enough to respond to emergencies within hours
• Understands the parent's medical history and treatment preferences
• Can make difficult decisions under pressure without being overridden by other family members
• Is willing to advocate with physicians and facility administrators

Always designate at least one alternate agent in case the primary agent is unavailable, incapacitated, or unwilling to serve. If no alternate is named and the primary agent cannot act, the family falls back to Arkansas's default statutory surrogacy rules — which are temporary, limited, and do not cover long-term residential placement decisions.

Common Pitfalls

Assuming a financial POA covers medical decisions. It does not. Arkansas law draws a sharp line between financial authority (Title 28, Chapter 68) and healthcare authority (§ 20-6-103). You need both documents.

Not distributing copies. The healthcare POA must be on file with every provider who treats your parent — the primary care physician, the local hospital, the specialist offices. A signed document in a filing cabinet at home is useless during an ER admission at 2 AM.

Waiting until the parent is in the ICU. The parent must have mental capacity at the moment of signing. A dementia diagnosis does not automatically eliminate capacity — someone with early-stage cognitive decline can still sign during a lucid interval — but the further the decline progresses, the higher the risk that the document will be challenged.

The Arkansas Power of Attorney & Guardianship Kit for Aging Parents walks you through both the healthcare and financial power of attorney documents, with Arkansas-specific instructions for execution, witness selection, and distribution.

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