Exploring a Challenging Conversation

Educating patients and their loved ones about hospice care, and how it can boost quality of life, is one of our goals at Liberty HomeCare & Hospice Services. Hospice care is not an easy topic to address. After all, many patients feel like they are giving up, or fear that end-of-life conversations may create anxiety or added stress for loved ones.

Tips for Starting the Conversation about Hospice

End of life conversations can be difficult to address, but understanding the rewards from the quality of life that follow can help make starting those conversations a little easier. Most people prefer to have their end-of-life care at home, and those at the end of life typically live longer under hospice care than without it. Determining that care, and what tactics will be used in a patient’s final days, can create peace of mind and alleviate some of the stress that inevitably comes when a family member’s condition worsens.

Start the Conversation Early

It’s also important to start talking about end of life as early as possible. Indeed, this gives loved ones the best opportunity to express their wishes before there may be a time when they are no longer able to speak on their own behalf.

How do you start the conversation?

Consider these tips below to start the dialogue with a patient’s doctor, which may be easier than starting that conversation with a loved one. These tips includes questions to address and valuable links to make the conversation a little easier.  It discusses questions about advance directives, medical treatments, and other preferences that a patient may have.

The following questions can help you determine what’s right for you as you begin end-of-life care conversations with your doctor:

  1. When it is your time to die, where you like to be, and with whom?
  2. If your preference is to die at home, what would you need to make that happen? Who would be your caregiver?
  3. How do you feel about depending on others at the end of life?
  4. Do you want to know if you have a terminal illness? Do you want others to know? Why or why not?
  5. What do you think a physician’s role should be in discussing end-of-life issues?
  6. What are your greatest fears about end of life? What would help reduce those fears?
  7. If faced with a terminal illness, what would be most important to you? What would it mean to live well for however much time you have left?
  8. Do you have an advance directive (i.e., a living will or power of attorney for healthcare)? Do you know how to get one? Do you know how, and when to update your advance directives?
  9. How do you think you would react if your doctor tried to discuss end-of-life care options with you? Would you feel your doctor wasn’t doing everything possible to cure your illness and save your life?
  10. If it was determined that you were terminally ill and could no longer eat and drink on your own, would you want artificial nutrition and hydration (e.g., a feeding tube and intravenous fluids)?
  11. If you could no longer breathe on your own, would you want to be hooked up to an artificial breathing device (a medical ventilator)?
  12. Do you feel comfortable talking to your physician about end-of-life issues?
  13. Have you had the conversation about your end-of-life wishes with your family members and healthcare providers? If not, are you going to discuss these matters with them, and if so, when?
  14. What do you know about hospice? How did you learn about it? What experience have you had with hospice?
  15. Do you know what hospice services are available to you?

For more information about initiating end-of-life conversations, visit http://www.considertheconversation.org/.

Creating a clear plan of action will help families make the most of the remaining time they have with a loved one.

That’s what end of life care is about: increasing the quality of life for all involved.