Did you know that nearly half of older hospitalized patients need a surrogate to help them make major medical decisions? According to researchers, a large number of those ages 65 and older need assistance from a medical decision-maker, often a relative or close friend. Statistics show that the vast majority of those decision-makers are women. Estate planning experts say that this population of health care surrogates is suffering from excessive stress because too few people are preparing advance directives to help guide their own medical care.

A study in a highly regarded medical journal has demonstrated the importance of discussing advance directives with the loved one who will serve as a health care surrogate. Those who know their relative’s wishes — through a living will or other document — are far less likely to experience such acute emotional distress. Rates of substance abuse also drop, and the grieving period after a major event is shortened.

It is admittedly difficult to be a health care surrogate. These individuals, most of whom are women, must consider where their relatives will live during their last days. They are also tasked with making major decisions about end-of-life care such as the use of ventilators and other invasive treatment options. Although you might think that most of the decisions about end-of-life care are made by the team of treating physicians, it is in fact the health care surrogate who is responsible for the majority of these choices.

Despite these facts, only about one in three Americans has a living will or other type of directive for end-of-life care. Many of these have chosen health care surrogates, but fewer than 10 percent have actually included actual guidelines for their medical care. Taking the time to create a living will and accompanying documents can make a huge difference in the health and welfare of your surrogate, and it can allow you to receive the care you want.

Luis E. Barreto