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Decisions, decisions

This week we learn how to make decisions about who should represent us if we can't speak for ourselves...and how to overcome common decision-making challenges.

Some of us don't formalize our choices about who should help us in an emergency, accident, or illness because we get stuck on the decisions and aren't sure how to talk about it. Let's talk about the responsibilities of surrogate decision makers and the attributes that make someone a good choice. 

Healthcare Proxy Responsibilities

Your healthcare proxy (or medical decision maker) is responsible for making medical treatment decisions for you, talking with your doctors, and advocating for you in medical and long-term care settings. A medical decision maker is assigned in an advance directive or healthcare power of attorney document.

Choose a medical decision maker who:

  • Knows you well
  • Supports your choices
  • Can make quick decisions
  • Can be a strong advocate
  • Can get along well with your financial decision maker (if not the same person)

NOTE: If you want more info on the types of choices your medical decision maker may face, the National Institutes of Health has an in-depth advance care planning guide.

Attorney-in-Fact Responsibilities

Your attorney-in-fact (or financial decision maker) is responsible for acting in your best interests to manage your financial, legal, and property matters as specified in your Power of Attorney document.

Choose an attorney-in-fact or  financial decision maker who is:

  • Honest
  • Financially responsible
  • Organized
  • A good communicator
  • Able to work well with your medical decision maker (if not the same person)

Don’t Forget to Ask

Once you've determined who you'd like to represent you, don't forget to ask if they're willing! Make sure they understand the responsibilities of the role.

Common Challenges


You have more than one choice…
Sometimes you’re lucky enough to have multiple people in your life who are able and willing to make decisions on your behalf. If you are in this situation, you may want to consider additional factors to help you decide, like someone’s professional qualifications, geographic proximity to you, and/or communication skills (here's a tool that can help.) Many families make big decisions together. If your family operates this way, I still recommend you name ONE person to facilitate discussions and speak for the group. 


You don't have a family member or friend to ask…
If you don’t have a family or friend to ask (or if you simply want someone that doesn’t have an emotional involvement with you to help make decisions), consider naming a professional fiduciary. Professional fiduciaries can serve a variety of roles (for a fee.)


You just can't decide…
If you need help deciding, ask friends or other family members how they made their decisions. That helped me make my choices. If you still need help weighing the pros and cons or have questions specific to your circumstances, consider bringing in a professional. Generally speaking, financial advisors, attorneys, care managers, or doctors would have the skills to help you make these decisions. 

Sharing Your Decisions

Once you've determined who will represent you, don't forget to share your decisions with the other important people in your life. Clear roles and responsibilities can reduce stress during challenging times.


Here are some tips to set the stage for productive conversations:

  1. Set a specific time and choose a place. While you might have some luck with fly-by conversations, it generally helps to deliberately set aside time for the conversation. Choose a place where everyone is comfortable, can hear, and has enough time for meaningful discussion.
  2. Give a “trigger warning.” Let the person know ahead of time what you’d like to talk about. Some people prefer to mull things over and don’t like to improvise. Giving a heads up on the subject matter can lead to a more productive conversation.
  3. Practice. Review in your own mind why you’ve made the decisions that you have so you can stay true to yourself if the conversation gets difficult.

If you expect conflict or are nervous about these conversations, leadership expert Fred Kofman, PhD. in Economics, Professor of Leadership at UFM explains in this short video how to remain true to yourself and, at the same time, open to your counterpart:

NOTE: There’s also a free discussion guide to help you prepare for difficult conversations on the LeanIn.org site.

Conversations on touchy topics can sometimes be uncomfortable, but with some preparation and persistence, they can bring you closer to your confidants and give you all greater confidence that you’re ready for whatever might lie ahead. 

Need Help? Join Us on Slack!

This week's tasks have included some really big topics. If you need help, or just want to chat, you can find me and others who are making their own Peace of Mind Plan there. 

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