Having conversations about what a loved-one would like if they can’t make medical decisions for themselves can be challenging. Starting these talks before a medical crisis is ideal. This will give you confidence that choices made are in line with what the person would have chosen for themselves. It’s impossible to come up with every medical scenario that might happen, but you can get a sense of what makes life meaningful to a person, and what quality of life they might not want to prolong. Some people are very clear that if they can’t live at home anymore, that would not be a good quality of life. Others wouldn’t mind living in a nursing home or care home as long as their family could visit. Some people wouldn’t want to be bedbound and fully dependent for care. There may be specific activities that make life most meaningful, and being unable to do them anymore would diminish quality of life. Some people may be clear that they don’t want to be on life support or in an ICU. Once you understand what the goals are, the medical team should be able to guide what treatment makes the most sense. 

It is important to have documentation of what is important and to assign a trusted person to make decisions. Each state has specific documents that are legally recognized. It's important to use the right ones and have the signatures witnessed or notarized depending on what is required. Make sure that you follow the instructions for witnesses and who cannot serve in this capacity. If the form requires a notary, there are often mobile notaries who can come to your home.