Important Planning Tool for Adults in Oakland County — And How They Protect Medical, Mental Health, and Placement Decisions

Families in Farmington, Farmington Hills, and across Oakland County often reach out to our office when an adult is struggling with medical decisions, mental health stability, or daily functioning. The first question is usually: “Do we need a guardianship?”Often, the answer is "it depends."

Michigan law provides powerful, voluntary tools that allow adults to choose who will help them — without court involvement and without losing their rights. The document we emphasize most in our Farmington office is a Patient Advocate Designation (PAD). When properly drafted, these documents can stabilize medical care, support mental health treatment, and prevent the need for guardianship.

Patient Advocate Designation: Critical for Medical, Mental Health, and Placement Decisions

A Patient Advocate Designation (also called a Health Care Power of Attorney) allows an adult to appoint someone they trust to make medical, psychiatric, and placement decisions if they become unable to do so.

How a PAD Supports Mental Health Treatment

A PAD can authorize the patient advocate to

Consent to psychiatric treatment

Approve or decline psychotropic medications

Coordinate outpatient mental health services

Work with hospitals and crisis teams

Make decisions about placement during periods of instability

For adults experiencing depression, bipolar disorder, schizophrenia, or cognitive decline, a PAD ensures continuity of care and prevents gaps in treatment when symptoms impair judgment.

How Hospitals Use a PAD for Medical and Placement Decisions

In Oakland County hospitals, medical staff routinely rely on a valid Patient Advocate Designation when the adult cannot make informed decisions.

With a PAD in place, hospitals may allow the patient advocate to:

Consent to surgeries, procedures, and diagnostic testing

Approve or decline recommended medical treatment

Authorize transfer to rehabilitation, psychiatric units, or skilled nursing facilities

Participate in discharge planning and placement decisions

Work with social workers and case managers to determine the safest environment

This is especially important during:

Medical crises

Psychiatric hospitalizations

Cognitive decline

Situations where the adult is confused, disoriented, or unable to understand risks

Without a PAD, hospitals often require a court‑appointed guardian before making major decisions — delaying care and complicating discharge planning.

Why Timing Matters

The adult must be of sound mind to sign a PAD. Once mental illness or cognitive decline progresses to the point of impaired insight, the opportunity to sign may be lost — leaving guardianship as the only option.

This post is for educational purposes only and does not constitute legal advice. Reading this information does not create an attorney–client relationship with our office. Every situation is unique, and laws can change. If you need guidance about your specific circumstances, you should consult with a qualified attorney licensed in Michigan.