It starts with a question. Who will make decisions for you when you cannot? Then, will decisions made on your behalf be what you want? These are issues that often do not have easy answers.

Many people face this dilemma while preparing their Powers of Attorney for medical and financial decision-making. Many more are greeted at the door of a hospital to make these decisions before having a scheduled surgery. Others like myself have been faced with trying to make decisions for a loved one without the benefit of having had a conversation about the person’s wishes or having any legal documents to refer to.

Making these decisions ahead of time enables your wishes to be carried out. They are based partly on your values, beliefs and experiences. After you make those decisions, it is important to have a conversation with the decision maker about what you want. For many, the decision maker is a family member, an adult child. This can be a difficult effort — expressing how you feel about your choices for the end of your life, and being explicit about what you want and don’t want. Having this conversation, albeit hard, can make the difference for your decision maker.

Consider this scenario. A doctor comes out to talk with your decision maker, needing consent for different procedures. How does your decision maker know what to do? They may have a copy of your Life Care Directive or Living Will, but it may not list every possible treatment option that the doctor can offer.

When the doctors asked my family what we thought my brother wanted for treatment options while he was unconscious after an accident, we had nothing that was written down to fall back on. What we did have as a collective were things he had said in passing, such as, “I don’t ever want to be like Terry Schiavo,” or “If I can’t throw the ball from the pitcher’s mound and hit the catcher, I don’t want to be here.” We were lucky that all of us interpreted his musings in the same way and agreed about what he would want. That is what this is all about — what he would have wanted.

Being a surrogate decision maker is hard enough in an end-of-life situation. But not to have a good idea about the wishes of the person who you are making a decision for makes it rife with guilt and anxiety. One of the best gifts you can give to someone who will speak for you is to prepare them well. One part is to have your estate planning as complete as possible; Powers of Attorney updated, will updated and a Living Will completed. Having the conversation helps to convey the spirit of your directives. This allows the decision maker to not fret about the details and to feel assured that the decisions are exactly what the loved one would have wanted.

Betsy Zuber, geriatric specialist, has been working in the field of aging for 17 years. Contact her at (206) 275-7752, betsy.zuber@mercergov.org or MIYFS 2040 84th Ave. S.E., Mercer Island, WA 98040.