This past week we remembered our loved ones who have gone before us. Some gone too soon, some at an advanced age, others due to illness.

As physicians, it is our job to prolong life. But despite all our expertise and technological advances, medicine still has limitations.  None of us are meant to live forever.  We're all going to have to say goodbye at some point.

Some patients let their families know of their wishes ahead of time, in case of an emergency or a critical illness.  But unfortunately, and all too often, most are unprepared, and these issues are really something they ever discussed or ever considered. What happens then is that the burden of deciding a patient's fate falls on the family, whose unyielding love and devotion becomes easily clouded by guilt and false hope. 

It is also the duty of physicians to ease suffering.  And rather than grasping at every possible way to stave off the inevitable, we must try to focus instead on accepting it. In my 14 years of practice, I have learned that we need to guide our patients towards what some might call a "good death," where suffering is alleviated and dignity preserved.

It always seems too soon — until it's too late. Whatever your opinion may be on end-of-life decisions, the question is always one of control – and who is going to have it over our bodies in its last moments. Why leave the burden of this choice to someone else?  You know yourself best. Everyone else can only guess. Leaving these choices to your family puts them in a precarious position. One where they are asked to make vital decisions for you while being in the most stressful environment imaginable. Facing the harsh reality of our mortality can be painful enough, saying goodbye to a loved one, even more so.

There is no perfect time for this discussion but here are some steps to consider to help provide peace of mind and support for your loved ones during a challenging time.

1. Communicate with your family and loved ones. Discuss your end-of-life preferences and financial matters so they understand your wishes.  You can include your physician in this discussion to explain your medical condition.

2. Have advance directives. These are legal documents that communicate your wishes about health care decisions in the event you are incapable of communicating these decisions. This can be a written document or you can appoint a healthcare proxy, someone who can make health care decisions for you.

2. Appoint a guardian.  If you have minor children, designate a guardian who will take care of them in your absence.

3. Seek professional advice.  Consult with financial advisors, estate planners or attorneys to ensure your affairs are in order.

4. Create a will. Draft a legally valid will that specifies how you want your assets distributed. You can consult with an attorney for this.

5. Medical and life insurance. Consider purchasing insurance to help with health care costs and to provide financial support for your family.

6. Organize important documents. Keep all your important documents in a secure location and inform a trusted person where to find them.

7. Plan your funeral. Prearrange your funeral or burial plans if you have specific preferences. There are insurance plans available for this as well.

8. Update regularly. Review and update your plans as circumstances change.

So, take time to reflect and make your wishes known. Caring for a loved one or parent at the end of life is easier if you've planned for it. Talk to your family and involve your doctor. And although we all see ourselves dying in old age, it's healthier to already think about it and bring it up, just in case.  That way, it can be about your own personal wishes as well as the wishes of your loved ones.  And this will help them cope with some of the changes they may face after you're gone.