How to Be a Health Care Proxy

REMEMBER Being a good proxy means speaking for the person when they're unable to speak for themselves.

Being a proxy is not about what YOU want; it is about what the person you're speaking for wants. In any situation where you have to act as a proxy, ask yourself, "If he/she were able to speak and to make a decision right now, what would he/she say?"

A SISTER TO HER BROTHER "This was Mom's choice. Now we have to be her voice."

Being a good proxy is about doing your best.

Being a good proxy isn't about being perfect -- it is about doing the best you can. Sometimes it's not possible to follow the person's wishes: maybe they said they want to be home, but it is not physically, financially, or safely possible to keep them there. In that case, just do the best you can. "The best you can do is the best you can do."

A LETTER FROM A MOTHER TO HER FAMILY "If you are faced with a decision that you're not ready for, it's okay. I'll try to let you know what I would want for various circumstances, but if you come to something we haven't anticipated, it's okay. And if you come to a decision point and what you decide results in my death, it's okay. I will die because of my illness or my body failing or whatever. You do not need to feel responsible."

What if someone asks you to be their proxy, but you are not comfortable saying yes?

It's okay to decline the invitation. For whatever reason, you might not feel you can take it on. Maybe you just are not comfortable with the person's preferences. Or maybe you feel like you could not bring yourself to make a decision that might shorten their life. Or maybe you are just too overwhelmed to take on the responsibility. If you are not comfortable saying yes, the best thing you can do is lovingly say no. Be honest. Say "Thank you for asking me -- I am honored. I just do not think I can do a good job being your proxy."

What if it is not possible to follow a person's wishes?

One of the hardest situations is when a loved one has clearly stated a wish, but it isn't a feasible option -- medically, financially, or because of limited family support. Perhaps the most common example of this is when a loved one has expressed a clear wish to die at home, but it's not a feasible option.

There are no easy answers. But one thing you can do is find out what matters most to the person about "home" -- and then do your best to come as close as possible. That might mean bringing in family pictures. Or a favorite piece of clothing or a favorite blanket. Or playing favorite music. Or having a visit from the family dog or cat. Or a taste of favorite food.