You are unexpectedly incapable of making your own decisions.
It is clear you will have little or no recovery.
Your injury or loss of function is significant.
This may have happened because of an injury to your brain from an accident, a stroke, or a slowly progressive disease such as Alzheimer’s.
Family members who have lived through situations such as these have told us that general statements, like “I don’t want to be a vegetable,” or “I don’t want to be hooked up to machines for the rest of my life,” are not enough information to help them make the decisions you would make during these very stressful situations.
It might help to start by talking about what life would be like for you if you could live well until your last day on earth.
What kinds of people, activities, and things would you want to enjoy?
Do you think you must be able to walk and live independently?
Would you be content sitting by the window in a nursing home watching birds at the feeder?
Next, you may want to think about situations in which you might choose to limit your life support options.
When would a ventilator in the Intensive Care Unit be helpful?
When should your Health Care Agent say no to a ventilator?
When would tube feedings be helpful?
When would it be time to stop a tube feeding?
Are you familiar with your religion’s position on end-of-life concerns?
Advance Care Planning has end-of-life position papers from most major religions. If your faith is important to you, talk to your priest, pastor, rabbi, or other spiritual leader to make sure you know what your faith says about this important decision.
Advance Care Planning has many simple tools that can help you describe your values. Please call us if you need assistance getting started.
Discuss Your Decisions
It’s Important to Have These Conversations Now Whether you are 25 or 75, discuss your decisions with the people in your inner circle now. Too often these issues aren’t addressed until you are admitted to a hospital with a life-threatening situation. In that event, you may not have the capacity to make your own decisions, and the choices will fall on the shoulders of your distressed family members in the waiting room. Families in this kind of situation tell us they feel like they are playing a guessing game, and are unprepared to speak for you.
Set the Tone Done early enough, this doesn’t have to be a dreaded, difficult conversation. Many people have found ways to inject a light-hearted attitude into this discussion.
Suggestions to get you off on the right foot:
Pick a time when many people from your inner circle are gathered together.
Have forms for everyone, not just you.
Set the Ground Rules
Remind people that Michigan law requires each of us to make this decision for ourselves and to ask someone else to speak our words for us if we ever can’t speak them ourselves.
Go around the group as you discuss things, asking everyone to say what they would choose for themselves.
If an answer surprises someone in the group, give everyone a chance to discuss their differences respectfully.
Advance Care Planning can help if you need assistance with this step.
Choose a Health Care Agent
Name the person who will be your Health Care Agent or Medical Decision Maker. If your physician and another health care professional find that you can no longer make health care choices, this is the person who will speak for you. He or she will act on the information and values that you have shared. Many people choose a close family member, but you may select anyone you think would best represent you.
The person you appoint should have all of the following qualifications:
18 years of age or older
Knows you well and cares about you
Trustworthy
Reachable in the event of an emergency
Willing to follow the values and instructions you have discussed
Willing to stand up for you and insist your wishes are honored
Able to make complex, difficult decisions during stressful situations
Willing to accept this responsibility
The person you choose should not be your health care provider, the owner or operator of a health or residential care facility serving you, or an employee of your health care provider.
The kinds of decisions your Health Care Agent may be asked to make for you include:
Signing for release of your medical records and personal files
Applying for Medicare, Medicaid, or other programs of insurance benefit for you
Arranging for your admission to a hospital, hospice, or nursing home
Giving consent or refusing medical services for you such as tests and surgery
Making the decision to request, take away, or not give medical treatments, including tube feeding, hydration, or any other treatments being used to prolong your death, based on your values or wishes
If you are a Munson Healthcare patient and have a compliment,
concern, or complaint, please contact one of our Patient
Liaisons.
Family members who have lived through situations such as these have told us that general statements, like “I don’t want to be a vegetable,” or “I don’t want to be hooked up to machines for the rest of my life,” are not enough information to help them make the decisions you would make during these very stressful situations. 
Name the person who will be your Health Care Agent or Medical Decision Maker. If your physician and another health care professional find that you can no longer make health care choices, this is the person who will speak for you. He or she will act on the information and values that you have shared. Many people choose a close family member, but you may select anyone you think would best represent you.