What 'professional next of kin' means, and when it makes sense

Maybe you have searched for a service that could stand in as your next of kin. Someone the hospital can call, who knows what you want, and who has the legal right to say so. That is a reasonable thing to look for, and the honest answer has two parts.

The first part is about how the law works. The second is about what you can put in place instead. Both fit inside a bigger question we cover in who decides for you when you can't.

What does "next of kin" mean in law?

"Next of kin" is not a job anyone can apply for. It is a list the law writes for you, ranked by family relationship, that applies when you haven't named anyone yourself. You can read the general order in your legal next of kin, in order.

Each state writes its own list, and the lists differ. Washington is a useful worked example. Under RCW 7.70.065, if an adult can't consent to medical care, a provider looks for someone in this order:

1. A court-appointed guardian
2. The person you named in a durable power of attorney that covers health care decisions
3. Your spouse or state registered domestic partner
4. Your adult children
5. Your parents
6. Your adult brothers and sisters
7. Adult grandchildren, then nieces and nephews, then aunts and uncles, who are familiar with you
8. A close friend who meets the statute's conditions

Notice where a professional appears on that list: nowhere, except in the second spot. That spot belongs to whoever you name in a health care power of attorney. A trust company can't become your "kin." It can only be named.

Can a close friend step in without paperwork?

In Washington, sometimes, and only with effort. The friend must sign a declaration under penalty of perjury. It says they are a close friend and familiar with your values. It also says they know of nobody higher on the list who is willing and able. That declaration lasts up to six months, and the provider may rely on it but doesn't have to.

The same statute rules out anyone paid to provide your care, your physician, and staff of the facility where you live or receive care. So a paid professional can never qualify through this door. That is why naming matters so much: it is the only route a professional has.

If your state has no friend provision, the gap is wider. Our page on medical decisions without a power of attorney walks through what tends to happen.

So what is a "professional next of kin"?

It is an informal phrase, not a legal title. It usually means a professional you name ahead of time to do the things family would otherwise be asked to do. In practice that means filling the four roles in an estate plan.

Each of these is a power of attorney or a similar appointment. The executor and the trustee do their work mostly after death. The two powers of attorney do theirs while you're living.

Whoever fills these roles is a fiduciary. That means legally required to act in your interest and follow what you wrote. In Washington, an agent must act in good faith, within the authority you gave, and in line with your known wishes (RCW 11.125.140).

What a professional can do, and what it can't

A professional named in these roles can do a great deal of practical work. It can answer the hospital's call, share your written wishes, pay the electric bill, have someone check on the house, and later settle your estate. If no executor is named at all, an estate can sit unsettled for a while. What happens if you die without a will explains how that plays out.

There are also honest limits:

• A professional doesn't know you the way an old friend does. It knows what you write down. The more you write, the better it can follow it.
• It is not a companion. It can arrange for someone to walk the dog at four. It won't sit with you on a Sunday afternoon unless that is part of what you set up.
• It acts on what you decided. It shouldn't be guessing at what you might have wanted, and a good one will tell you where your instructions are thin.
• Its work costs money. A friend may serve for free (though in Washington an agent is entitled to reasonable pay unless the document says otherwise, under RCW 11.125.120).

When does a professional next of kin make sense?

It tends to fit if several of these are true for you:

• The people you'd most want to ask are your own age, or you'd rather not ask them at all.
• Your children or siblings live far away and couldn't get to a hospital quickly.
• You've seen a family argue over an estate and want to spare yours that.
• You'd rather the hard call not land on someone you love.
• You own a home or have retirement savings that would need real management.
• You want one plan that covers the hospital, the bills and the estate, not just one piece.

When is another choice better?

A professional is not always the right answer. Here is where something simpler may serve you well:

• You have a willing, capable person close by. A trusted niece or friend who lives nearby and agrees to serve may be all you need. A professional can still sit behind them as backup.
• You only want a medical decision-maker. A health care power of attorney naming a friend is a short document, and it may be all you need.
• Your affairs are simple. With no house and little money, a professional may cost more than the work is worth.

A popular middle path is to name a person first and a professional second. Washington law lets you name successor agents who act only if the first one resigns, dies, becomes incapacitated or declines (RCW 11.125.110). We explain why that matters in naming a backup in every role.

Where Kinly fits

Kinly is one way to set this up. A membership includes the four documents, written for your state. It names Trella Trust Company, a Washington State chartered trust company, in any or all four roles. You choose the order, so it can be first, or the backup behind your sister or a friend. The details are on how it works.

If you want to compare it with other kinds of help, choosing professional help sets the options side by side. The term we use for this kind of arrangement is a standby fiduciary.

Common questions

Can a company legally be my next of kin?

No. Next of kin is a status set by family relationship under state law. What a company can be is your named agent, executor or trustee. Once named, it generally acts ahead of the family list for that role.

Will a hospital listen to a professional I've named?

A hospital looks to whoever has legal authority. In Washington, your health care agent comes second on the consent list. Only a court-appointed guardian ranks higher. Bring or file a copy so the hospital can see it.

Do I have to name a professional in all four roles?

No. You can name a professional in one role and people in the others. Many people choose a friend for medical decisions and a professional for money and the estate, or the reverse.

What if my family disagrees with what the professional does?

A named fiduciary has to follow your documents and your known wishes, not a vote. Clear written instructions are the best protection. In Washington, a spouse or an interested person with a genuine concern can ask a court to review an agent's conduct (RCW 11.125.160).

Sources

• RCW 7.70.065: Informed consent, persons authorized to provide for patients who do not have capacity
• RCW 11.125.020: Uniform Power of Attorney Act definitions
• RCW 11.125.110: Coagents and successor agents
• RCW 11.125.120: Reimbursement and compensation of agents
• RCW 11.125.140: Agent's duties
• RCW 11.125.160: Court petition
• RCW 11.28.120: Order of persons entitled to letters of administration
• RCW 11.36.010: Who may serve as personal representative