How to Make Decisions for Someone at End of Life

When we think about healthcare choices at end of life, we may already have definite ideas of what our wishes are. The bigger challenge occurs when we are asked to make end-of-life decisions for someone else who can no longer make healthcare decisions for themselves.

In a perfect world, you would be asked to make end-of-life decisions for someone else because they discussed their wishes with you and asked you to take on this role. In the most perfect world, they would have put their wishes in writing and named you as their healthcare power of attorney.

In the absence of that request and documentation, the patient’s healthcare provider may ask you to step into this role or a court may assign this role to you as the patient’s closest family member, friend, or representative.

Healthcare providers and the courts want to ensure the patient’s best interests are being met, and the person or people closest to the patient can provide important insight into the patient’s beliefs, goals, values, wishes, and personal preferences so they can create a care plan that supports the patient’s physical, emotional, and spiritual needs.

Making End-of-Life Decisions for Someone Else

When asked to make end-of-life decisions for another person, it is important to remember that you need to put yourself in their mind and their shoes. Sit with their doctor and get as much information as possible about what is likely to happen and the options available. Ask them to talk to you about their quality of life, benefits and risks of treatment, and their level of pain and/or suffering. Find out what decisions you need to make now and what decisions will need to be made later.

As you consider all the options, good questions to ask yourself include:

• If this person could see their current condition, what would their goals be?
• What treatments would they consider beneficial?
• What risks or side effects would they believe to be burdensome or not worth the effort?
• Will the treatment (or lack of treatment) improve or reduce quality of life?
• How will it affect their ability to do things or communicate?
• If recovery is not possible, are there things they would want to minimize or avoid (pain, suffering, long-term mechanical support)?
• What is the doctor recommending and why?
• What would be most important to your loved one?

Let the person’s previously stated wishes, goals, and values help to guide your answers. If you need additional support, reach out to their healthcare providers, other important people in your loved one’s life, a counselor, social worker or therapist, or a religious advisor.

Accepting the Decisions You Make

One of the hardest parts of making end-of-life decisions for someone else is the pressure of wanting to do the “right” thing. Advance directives are a blessing in this regard because the individual’s wishes are spelled out in black and white. But without that guidance, a person may feel torn between allowing natural death and pursuing every possible treatment option.

This feeling is normal. After all, no one wants to feel like they “gave up” on a loved one or forced them endure a treatment or procedure they would have declined.  Try to find a decision that all the people important to your loved one can accept. But ultimately, if you truly act according to what you believe your loved one would have wanted for their final hours or days, you can take comfort in knowing you honored the person you loved and supported their wishes when they needed you most.

Crossroads Hospice & Palliative Care provides support to patients and families facing serious and terminal illness. To learn more about our programs, please call 1-888-564-3405.

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