Beginning End-of-Life Care Discussions

No one welcomes contemplating their own mortality, let alone having difficult discussions about it. Nevertheless, it is crucial to engage in these conversations with both your family and healthcare team. This ensures that your wishes for end-of-life care are respected. By openly sharing your goals of care, you can more fully prepare yourself and your loved ones for what lies ahead.

What are end-of-life preferences and goals of care?

End-of-life preferences involve decisions about medical treatments you want or don't want if you can't decide for yourself. These might include life-sustaining actions like CPR, ventilators, and tube feeding, as well as comfort measures such as pain relief and hospice. On the other hand, goals of care are personal and emotional objectives that can guide medical choices near the end of life. For instance, these might include dying at home, being free of pain, or staying mentally alert.

Why are these conversations important?

Discussing your choices about end-of-life care and goals can ensure that your wishes are respected by healthcare providers, family, and loved ones. It can also relieve the pressure on loved ones facing tough decisions in a difficult time. By defining your wishes and goals, you can gain more peace of mind and peace about the end of your life.

How can I initiate these conversations?

Initiating these conversations can be daunting at first. Here are some tips on how to get started:

1. Pick the right time and place:

Choose a time and place that allows for uninterrupted and private discussion. You might prefer to do it in person, over the phone, or through a video call, depending on your comfort level and location.

2. Share your motivations:

Explain why you want to have this conversation and why it matters to you. You might say something like, ?I want us to be on the same page about my care in case something happens to me. I want to make sure that my wishes are respected.?

3. Ask open-ended questions:

Start with open-ended questions to encourage your loved ones to share their thoughts and feelings. Examples include, ?What are your thoughts on end-of-life care?? or ?What would be most important to you if you were in my situation??

4. Be clear and specific:

Express your preferences and goals in clear and specific terms. For example, you might say, ?I do not wish to receive mechanical ventilation if it will not improve my quality of life? or ?I want to be as pain-free as possible, even if that means limiting life-sustaining treatments.?

5. Listen and be responsive:

Remember that these conversations are a two-way street. Listen carefully to your loved ones? input and be responsive to their concerns and questions. If you have difficulty understanding or expressing your preferences, consider consulting with a healthcare professional or a spiritual counselor for guidance.

Who should I be involved in these conversations?

It's important to include all individuals who could be participating in your end-of-life care, such as family, friends, healthcare providers, and financial advisors. Although it may feel uncomfortable discussing these topics with some people, including everyone who might influence your care is important. This helps avoid confusion and likely conflicts later on, particularly when multiple decision-makers have different opinions.

What if I change my mind?

Keep in mind that end-of-life preferences and goals of care are not set in stone. It?s normal to reevaluate and adjust them as your health status or personal circumstances change over time. It?s important to communicate any changes in your wishes to your loved ones and healthcare providers so that they can adjust their plans accordingly.


Talking about preferences for the end of life and goals of care can be challenging emotionally, but it's crucial to ensure your wishes are respected, and your those you care about are given guidance during a crisis. By beginning the talk early, being clear, and involving all those making decisions, you can reduce uncertainty and in the end attain a peaceful and dignified end of life.

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