To be fair, Belle was in Hong Kong, so that would have made it a bit difficult for Marlena to use her. However, it would have been UNLIKE Marlena not to have said something to Belle, whether by phone or text, or e-mail......"decided to take your advice, had the advance directive drawn up"..........and especially to notify her she was health proxy. I mean, Belle was in Hong Kong. If a situation arose back in Salem, how the heck would anyone know? And perhaps I am wrong.....but isn't a health directive filed with the hospital? Put in your medical records file?