When a patient cannot speak for themselves and their loved ones are unclear about that patient’s wishes, this leaves the health care team with little to no guidance as to how to proceed in a moment of crisis. In addition, sometimes there is confusion about which loved one should be making the medical decisions in this situation.

We can help avoid this scenario by designating our specific wishes and deciding who will carry them out by filling out the appropriate paperwork and then having conversations with our loved ones.

The first step on this journey will be to fill out the Medical Power of Attorney (see link below) and to choose the primary agent (decision maker) and then two secondary, alternate agents, in case the primary agent is unavailable. These agents can be family members or close friends, whoever is willing to step up and speak with doctors and hospitals on our behalf.

The next step is the Advance Directive to Physicians (second link below) where we state what we would wish our designated agent would tell doctors to do if we are unable to make our own health care decisions for whatever reasons.

The hardest part of this process will be talking to the loved ones selected to make these decisions. While the paperwork satisfies the legal part, the emotional issues need to be discussed with the loved ones. During this conversation, it would be a good time for everyone involved to become educated about medical decision-making:

– The “Toolkit for Advance Health Care Planning” by the American Bar Association is a great resource for guiding us through this process.

-The Five Wishes Project has a workbook for writing down this process as does the Y Collaborative which also offers consultation services.

Prepare for Your Care has resources in both English and Spanish.

-And once a year, National Health Care Decision Day is held every April 16th with the idea of taking care of taxes the day before and taking care of health care planning the following day.

This discussion will probably be very emotional and might even involve tears. After all—we will be talking about potential serious, life-threatening scenarios and possibly end of life issues which is why many of us procrastinate or avoid this topic altogether. Yet, a difficult conversation now can save much confusion and heartache later.

After the papers have been signed and witnessed (or notarized) and discussions have been held, copies need to be distributed to the appropriate loved ones. The originals should be kept in a safe place. In this day of portable electronics, even storage on smart phones or computers might be advisable as well.

Here are the two documents needed with instructions included. Please feel free to download these forms and share the link with others. Preparing these documents can be a tough journey, but one worth taking for the peace of mind it will bring us and our loved ones.

State of Texas Medical Power of Attorney form:


State of Texas Advanced Directive to Physicians (Living Will):