Appoint a Healthcare Proxy and at least one alternate with a good deal of thought. (The alternate is in case something happens to your first choice, or he or she chooses not to serve when the time comes.)

Most people appoint a spouse or adult child without considering whether he or she is suitable for the job. For instance, Rose appointed her husband John to be her Proxy on the understanding that he would turn off a ventilator if there was no reasonable chance for her to recover. When Rose ended up in that situation, John insisted that she put on a ventilator. He even fought to keep it on. He said he had depended on her all his adult life and he couldn't imagine living without her.

Because of the potential for conflict and confusion, it is better not to appoint more than one person in each position.

Once you have a person in mind, have a discussion about your wishes, the person's understanding of those wishes, and his or her willingness to enforce them. The six steps to take to be sure there is a mutual understanding are spelled out in the article linked to in "To Learn More."

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