The best way that I have found to have discussions about what someone wants or does not want when faced with health care decisions, is to bring as much of the family together as possible. Do it while you are healthy before it is too late for you to tell others what you wishes are.

Sit around the kitchen or dining room table with coffee and cookies or cake, and start talking about your values - what is important to you in terms of quality of life and life functioning. For example, if you believe that what is most important is that you be able to communicate, then you need to let your family know that. If you want everything done no matter what the outcome, you need to let your family know that as well.

Have blank Health Care Proxy forms available. (Download a proxy form here) Suggest that everyone at the table over the age of 18 complete one. Think about who you would want to make your health care decisions for you if you are unable to make them youself. Make sure that the person you select (can be blood-related or not) is willing to follow through on what your wishes are. Remember, they are speaking for you because you cannot speak for yourself. Be sure to select someone who is willing to put aside their own preferences in order to ensure that your wishes are honored. This person will have access to your medical records, will speak with your doctor and other healthcare providers and be included in any medical decisions that are made about your medical care.

Select a substitute proxy who will fill in if the Proxy is unable or unwilling to make decisions that are in keeping with you wishes. It is important that you make sure that all family members around the table hear what each others' wishes are. This will make things easier if and when the time comes to make decisions that are in keeping with your wishes.

You do not need a lawyer to complete a proxy form, nor does it need to be notarized. You need to have two people - neither of whom is the proxy or substitute proxy - witness that you selected your proxies without coercion.

The only thing you need to make sure you specify on the proxy form is whether or not you want artificial nutrition and/or hydration. If you do not specify that your proxy knows your wishes regarding artificial nutrition/hydration, or that you do not want artificial nutrition/hydration, then the hospital MUST provide you with it. This does not mean that you will not receive artificial nutrition or hydration. What it means is that your proxy can ask that they be removed if there is no reasonable chance of recovery -if that is your wish. If you do NOT say anything about artificial nutrition / hydration, the hospital MUST continue to provide it to you no matter what the outcome of your physical being.

Whatever you decide, know that you can change your mind at any time. Ongoing conversations are an important aspect of having a Proxy. As you change and grow older, your values and choices may change. Be sure to let your proxy know if your wishes change. This is why I prefer a proxy form to a living will. A living will may not cover what happens to you or you may change your mind and then you would need to do new forms. With a proxy, keep the conversation ongoing.

Once your proxy is signed and witnessed, make a lot of copies of it. Keep one copy with your other important papers. Give your proxy and your substitute proxy a copy. Give your doctor a copy. If you have a local hospital that is the one that you will most likely be taken to, and you have been admitted there in the past, ask them to attach a copy of your proxy to your medical record. When you travel, take a copy with you. Other states will normally honor your home state's laws.

For more information, download: NY State Planning Your HealthCare in Advance