Starting the dialogue...with your family and friends

Staring a conversation with anyone about advance health care planning and end of life can be challenging. People are unsure how to bring it up and are unsure how to guide the conversation. One way to start is by talking to your family and friends about the death of a loved one, someone you know or a celebrity. What are your thoughts on the care they received? How is that similar or different to the care that you would like to have? 

Possible responses from family and friends

Why are you bringing this up? You don’t have to worry about that yet. Can’t we wait and handle things as they come up?
If we want to handle things as they come up, it may be too late. I am too important to leave to chance. I have been making decisions for myself all my life, and I want you to know what decisions I would make if, suddenly, I couldn’t do so for myself

Why do we have to talk about this stuff? Isn’t that the job of the doctors to make these decisions?
The doctors will help in the decision-making process, but they will still turn to my family and friends to make choices about me. It would be difficult to know what choices I would want if I never told you. I’m only looking out for you, so the burden of decision making doesn’t fall solely on you.

This is too hard and depressing to talk about.
Yes, it can be hard to talk about. Talking about it now is a gift I am trying to give to you. It’s a gift to show how much I care for you, because it will be much harder to talk about later.< p/>

Topics you may want to talk about when having the conversation

  • If you could plan it today, what would the last day or week of your life look like? Who would be there? Where would you like to be?
  • What are your fears or concerns about the process of dying?
  • What care would you want during a severe illness or as you were dying?
  • What kind of care would you like to receive if you found yourself suddenly in a vegetative state?
  • Where would you prefer to spend your last days if you were ill? At home? At a nursing home? In a hospital?
  • Who would you want to make medical decisions for you if you are unable?
  • What are your beliefs about how long life should be preserved? Are there any physical or mental conditions that would make you believe that life-prolonging treatment should no longer be used?

After you have had the conversation, it is important to document it. This can be done by completing an Advance Directive form. After the form is completed, give a copy to your health care provider to document in your electronic health record. Please see Create Your Advance Directive for instructions on how to begin.