Why you should talk about designating a health care surrogate

DON’T WORRY ABOUT HURT FEELINGS Naming whom you want is more important than sparing feelings: Your future medical life is too important to consider people-pleasing. Your closest relative

(like a spouse or child) flat-out may not be the best choice to be your surrogate. For example, your children may have horrible sibling rivalry that would certainly not end during a medical

crisis, and they would butt heads as co-surrogates. If your best friend is the person you trust who meets all the other factors, then name him or her. If you know one child is responsible

and the other is not, then name the responsible child. It’s far more important to have the person you feel most confident in than the “obvious” or “peacemaking” choice. ADJUST DOCUMENT AS

CIRCUMSTANCES CHANGE As you move through this list of considerations, do not fret if you aren’t 100 percent confident in your first choice. First, your health care surrogate designation can,

and should, name alternate surrogates in the event your first choice is unable or unwilling to serve. Second, you do not need to imagine what your surrogate will be like 10 or 30 years down

the road. It’s more important to consider how they are today. You can create a new health care surrogate designation with ease if your wishes or circumstances change. MAKE YOUR HEALTH CARE

WISHES CLEAR Remember, the surrogate is only as informed as you make them. So, when you appoint your surrogate, talk to them about your medical care, including palliative care, and 

end-of-life wishes. If they don’t know what you would want, they should make decisions that they believe are in your best interests. And although it seems like a no-brainer, make sure they

have copies of your designation document. A missing document is just as useless as no document at all. INACTION MAY BE HAZARDOUS TO YOUR HEALTH Finally, be ready if you are met with

resistance or the question arises: “What happens if I do nothing?” The fact is that not choosing a surrogate designation leaves everything up to chance. Many states have default surrogate

laws that address who could act on an incapacitated person’s behalf, but the default surrogate may not be the person you would want. Further, a court may be called upon to appoint a guardian

for the incapacitated person. Guardianships, or conservatorships, can be extremely expensive and also run the risk of someone you wouldn’t want (or a stranger) making decisions about your

medical care. The stakes are simply too high to leave it up to fate. And if you’re met with total resistance to the conversation, it’s OK. You can always try again to impart to your loved

ones how much these matter and why. So, as you’re preparing for your next family gathering and marshaling your courage to have these difficult but oh-so-important discussions, check out the

ample online resources that will guide you to conversation starters about health care surrogates and the free state-by-state forms that you can print and fill out together. I wish you and

yours the very best of luck in creating a care plan and the comfort of knowing that you’ve talked and planned together to weather times of crisis.  _Editor's note: This article,

originally published in 2019, has been updated by the author._