Today we are going to discuss the important task of making decisions on the behalf of a loved one, a position you may find yourself in under a number of different circumstances. These decisions may be really big decisions, such as whether to continue life support, allow for extraordinary measures, donate organs and/or tissues, or consult hospice. They may be decisions made after a death regarding funeral services, cremation, and burial. Or they may be decisions about the disposition of an estate, belongings, and other personal effects. Regardless, making decisions on a loved one’s behalf can be difficult due to a desire to make the best decision possible.
Through our work, we’ve seen countless families with different dynamics and makeups make these types of decisions, and, as we have personally participated in making these types of decisions. So, in this article, we’d like to lay out a general outline for how to make these decisions based on our experiences and observations.
1. Investigate: Has anything been written down, documented, or signed?
Above all else, you will need to refer to any wishes your loved one has documented. Examples include a living will, advance directive, medical power of attorney, orders for life-sustaining treatment, organ and tissue donor designation, and any other type of last will and testament.
You may be surprised by your loved one’s wishes and you may even feel uncomfortable if they are inconsistent with what you want. I’m sorry though, the right thing to do is honor them. If your loved one wanted to be a DNR, then make them a DNR; if you loved one wanted to be an organ donor, then this is what needs to happen; and if your loved one wanted to give 30% of his estate to the Church of the Flying Spaghetti Monster then guess what – new colanders for everyone.
Your loved one has taken the time to write down what they want in an effort to have a voice in how they die, listen to them.
2: Ask: Who will be involved in decision-making?
The answer to this question will depend on the decisions at hand. You may want to limit the big decisions, to those closest to the individual. Whereas you may want more input from family and/or friends about other decisions, such as planning a memorial service or deciding on what to do with belongings.
Often the first question people ask when approaching decisions in general is ‘who has the power to make decisions?’ or ‘who is in charge?’. The answer will depend on a number of factors including the type of decision, whether someone has been appointed to make the decision and how far their power extends, the next-of-kin hierarchy, domestic partnership laws in your state, and your families specific approach to decision-making (ie. Do you wish to make decisions collectively? Does your family have its own internal hierarchy? Do you wish to appoint one or two specific people?).
You need to look at your specific situation to determine who’s ‘in charge’, whether that’s one person or a group of people. Then beyond that, decide who else should be involved. It’s generally recommended to keep it to those who truly ought to be involved, so if you’re not comfortable with Nancy from church being present for these decisions, please don’t feel guilty asking her to step out. That being said, some larger families have an equal-say decision-making process and we have seen groups of 10+ effectively make decisions.
If you have come here looking for advice resolving conflict with your aforementioned family, I’m sorry that’s a post for another day. We do have a post here on working with family while sorting through belongings after a death. Although this may not be your specific problem, some of the topics covered may prove helpful.
3. Talk amongst yourselves: Has your loved one ever spoken about their wishes?
Most people, if really forced, are willing to admit they will die. Many, if prompted, will discuss their wishes for their death in some way shape or form. Some, if really proactive, will actually go so far as to document their wishes. My point being, in many cases you won’t have an actual document, especially if the death was sudden, but you may be able to refer to conversations you’ve had with your loved one.
The thing about these types of conversations, they come up with you least expect them. After an episode of Greys Anatomy, at the DMV, at another person’s funeral, while contemplating the meaning of life – they could have happened at the most insignificant of times and with the more random of people. Talk amongst the family and friends involved in decisions and see if anyone recalls any specific wishes. Have you had any conversations like these with your loved one?
4. Consider: What does/did your loved one value?
Relying on what you know about your loved one’s wishes is great, but often you will have to make a decision(s) on your loved one’s behalf based only on what you know about the person. In these situations, you may need to infer what they would have wanted based on what you know about their values, likes, dislikes, and preferences.
When disposing of belongings, consider if your loved one liked to give to charity; when planning a memorial service, consider the parts of their life they would want you to highlight; if asked about organ and tissue donation, consider if they were a generous or selfless person. It may help to ask yourself, “If my loved one were here and able to speak for themselves, what would they say?” What do you think they’d tell you if you were chatting over a cup of coffee?
5. Decide: Based on all of the above, what do you think or know your loved one would have wanted?
Taking stock of everything you know, make your decision. The answer may not be crystal clear, but hopefully, you have been pointed in the right direction. When in doubt, follow your gut. You are most likely involved in making these decisions because you know/knew your loved one best, so don’t be afraid to follow your instincts.
Have a specific question about anything we’ve said? Feel free to ask in the comments or send us a private message. Also, don’t forget to subscribe to receive posts straight to your e-mail inbox.