How to Have a Conversation About End of Life Care

When you think about all the different things in life that you talk about with a loved one, death is probably at the bottom of the list, if it is on the list at all. Yet, it is one of the most important conversations that can take place. Having a conversation about the end of life can ensure that one’s wishes are met. It is the only way to know what your loved one wants to take place in many different circumstances and it is the only way to ensure that everyone in the family knows very clearly what your loved one’s priorities and wishes are. Here are some tips on how to have a conversation with your loved one about end of life care.

The Conversation Project1 has a conversation starter kit2 that you can download to organize your thoughts. It will guide you to think about the things you need to talk about and how to approach them in a manner that will foster a positive conversation.

Talk in a familiar place. It is best to have the end of life conversation with your loved one before crisis or sudden illness strikes. Choose a comfortable place in familiar surroundings and tell your loved one that there is something you want to discuss that it is important to you:

  • Begin by saying that you have been thinking about your ability to care for him and her and how important it is.
  • Explain any plans you have made to ensure that you have the time to be a caregiver should it be needed, whether it includes lining up babysitters for the children or saving vacation and personal days so you can take time off from work when necessary.
  • Discuss the fact that the process that led you to think about end of life and the need to plan that as well. Without planning, you can’t know what he or she wants at end of life.

Showing the commitment that you have made to caregiving helps your loved one to understand how important this conversation is to you and that it comes from a foundation of love and concern. Then begin to ask the questions about his or her wishes for end of life care.

Don’t be discouraged. If when you begin the conversation, your loved one resists or refuses to discuss end of life care, don’t be discouraged. Simply by introducing the conversation, you have opened the door to a more detailed conversation at a later date. You can say things like:

“Why don’t you think about it and we can talk about it later. It is very important that I know what you want so that I can honor your wishes.”

“I know this is difficult, but I can’t make sure that your wishes are respected if I don’t know what they are. I understand you don’t want to talk about this now, but we have to talk about it later.”

“I respect you and your feelings. I respect how you feel about this now. That is exactly why I want to have this conversation with you. I want to make sure that you always feel respected, even in your last days or hours.”

Give your loved one time. Start the conversation again in a month and bring a list with you that the two of you can share. Download the conversation starter kit listed above and use it as a tool in the conversation. If your loved one feels that he or she is answering questions on a form, it may make it feel less personal and less invasive. If this fails as well, leave the form with them. Suggest that they continue to think about the questions and fill out some of the blanks on the form. Whatever information they write down is more than you had before.

Seek a professional partner. Having a professional partner can provide the family with an objective guide, someone who responds to needs as they arise and makes sure all needed resources and services are in place. The Life Care Manager is your advocate.

These conversations won’t be perfect or comprehensive. Some people may resist talking about this in any way. However, if you continue to pursue the conversation from time to time your loved one may begin to understand how important it is to tell you their wishes. Continue to reassure them that the more he or she tells you the more you can protect them to the very end. If you have end of life care questions we have a number of resources here!

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1: The Conversation Project
2: Conversation Starter Kit

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