For my family, it happened during New Year’s Day supper. In one moment, we were gathering for a light meal to celebrate the New Year as a family, and two hours later I was meeting with an emergency department physician, providing him with a copy of my mother’s advance directives, and steeling myself for some difficult and painful discussions which could no longer be avoided. In two hours’ time, I found myself having gone from supper with family to be being surrogate acting on behalf of family. There was no warning, no emotional “warm-up”, just a sudden life-threatening illness and the need to start making decisions which I prayed were correct.

While the circumstances of this story may seem unfortunate, these events thankfully came with advance directives which provided both clear authority and unambiguous direction for the execution of that authority. Equally important was that my mother had wisely communicated her wishes and provided copies of her advance directives within the family. That decision proved to be a tremendous gift to each of us. And while it did not change the physiology of her disease, it provided great comfort to our family and meant that she maintained the dignity of having her wishes recognized and followed.

Often, we spend more time exploring the virtues of our next household appliance purchase than we invest contemplating our own wishes, communicating openly with our loved ones, and sharing our desires with our physician(s). Instead, we truly need to be honest with ourselves about what we want for our own healthcare and determine who would be our surrogate decision maker if the need arises.

So if you are not sure about when to start this conversation, consider doing it at your next gathering of family or friends. It is better to be prepared than surprised.

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