Sometimes, we can’t take care of ourselves. I’m not talking about the days when we struggle to get out of bed or do the chores or pay the bills. I’m talking about when we’re actually physically or mentally disabled so far that we are incapable of making decisions. It may be the result of an accident, an illness, or something else, but we can become unable to decide and communicate what we want done with regard to our health, finances, and families. For people with legal spouses or partners, or who have surviving parents who are themselves able to take on those types of responsibilities, it’s one thing. It’s another thing entirely when we’re navigating life on our own and don’t have another adult readily available to lean on in those emergency situations. So what then?
You start by thinking through all of the things that must be dealt with if you don’t. That includes family members you are responsible for, particularly children and elderly parents or other relatives for whom you are a caretaker. Consider what the backup plan would be for them, such as ensuring that another caretaker could take up the slack. If you own a business, you will also want to figure out if it would need to be shut down or if it could keep running, and who can take the reins either way so that the needed tasks are actually completed. If your finances are independent, you should determine which bills absolutely must be paid if and when you can’t click “pay.” Most importantly, if you are too ill or injured to decide, think long and hard about what kind of medical treatment you would want to allow or not allow. Then write down all of the decisions you’ve made today for those tomorrows you hope don’t happen. Make sure you include relevant information such as where someone can access necessary account information or who they need to contact, such as the names and phone number of your doctors.
Having all of that written down is only a start. Then you’ll need to start discussing these topics with trusted friends. They won’t be easy chats, I know, but that’s part of having a chosen family. You don’t just have happy times and happy conversations together. Sometimes, you gotta deal with the heavy stuff too, whether it’s by scheduling the talk or by bringing up relevant pieces when related topics come up. It might seem morbid to talk about things like the remote possibility of your own grave illness, massive accident, or death, but it’s a discomfort now that can prevent pain and drama later. If the worst should happen, do you want your friends-who-are-family to know what kinds of decisions you want made with respect to your health and how they should take care of other aspects of your life, or do you want your friends to worry not only about the circumstances you’re in but also what they should do about them? In the long run, the former is much less distressing, even has difficult as having those conversations today may be. And don’t just limit it to a one-time deal. Your views will change over time, perhaps because of these talks, and you will want to keep exploring them as they shift.
You’ll also want to select one or two very close friends to become your legal representatives to make those decisions. Hospitals and doctors rightly want to make sure the right people are making life or death decisions for patients, and banks don’t want to let just anyone at your money, so they can’t just take the word of someone who claims they’ve been your best friend since kindergarten. While an advance directive or living will can cover some of these issues by themselves, it’s really best to have an actual person who can make more nuanced calls that reflect the actual situation at hand. After all, while you can think through a lot of the possibilities, odds are pretty good that you haven’t been able to predict them all. In those cases, you need a human being who knows how you would think about the unique set of facts you’re stuck with right then. It’s a heavy responsibility and a difficult one to ask, but trust me when I say that it is also in the nature of bestowing an honor, a reflection of the deep trust you can have with another. Certainly, there are practical implications that affect who you choose, such as geography and other responsibilities your friends may have, but at the end of the day, this is why your most inner circle is more family than who you were born with, even if your inner circle of friends includes blood relatives. They are the ones who are willing to take on that burden, because you need it.
As part of doing the necessary paperwork – and I’d recommend consulting with a lawyer or other reliable resource – make sure you get it on record with places that might need it, and keep copies in accessible places. It’d be a good idea for those friends who are your representatives to have copies. When contacting organizations like your bank, your health insurer or your doctor’s office, you might find out that they need these things in a specific form before they will recognize them. Make sure you revisit these documents on a regular basis too. You might have included pre-made decisions that are no longer true for you, or you may have grown apart from the friend you selected or that friend may have had their life circumstances change so that they are no longer available to be that person for you. Today is a better time to find all of that out than when you’re already unconscious in a hospital bed.
It can be distressing and depressing to think about these possibilities, but it’s really important if you want to ensure that you are taken care of in the way that you want when you are unable to do so yourself. Taking that time today means it will be less of a worry in your future.