End-of-Life Care: How and When to Discuss End-of-Life Care

End-of-life conversations are not really for end of life.

We’ve said it many times before: End-of-life conversations about medical care, pain management, and memorial matters are not really for end of life. Individuals and families should begin having these conversations early and then continue the discussions over time. You might wonder why it’s so important to have these conversations early and often – because if you don’t know your options, you may not know what’s right for you, and if your loved ones don’t know your wishes, they won’t be able to make sure your needs are cared for as you would want.

So when is the right time to have an end-of-life conversation? Charlie Sabatino, Director of the Commission on Law and Aging at the American Bar Association, recommends discussing end-of-life issues whenever any of the following five Ds occur: a decade of your life passes, after the death of a loved one, a divorce, a new or serious diagnosis, or a significant decline in a condition. Why have this conversation multiple times? Because over time and with different life experiences, we may change our minds about the type of medical care we’d like to receive if we are seriously ill.

Sabatino also suggests putting your advance directives down in writing to communicate your wishes – without them you may have not have control over important medical care decisions that will be made if you ever get seriously ill. One resource for those thinking about end-of-life is Five Wishes, a living will that meets the legal requirements in 42 states. Their website enables individuals to print out a personalized document immediately. Once you’ve completed it, your doctor is required to follow your wishes according to the laws of your state. And if you change your mind, destroy the out-of-date copies, and distribute copies of your new document to  your doctors, family members, and friends. Five Wishes is not the only resource for advanced planning – there are many other workbooks and resources, like Your Life Your Choices, which consists of 53-pages that outline every possibility, and Caring Conversations, written by the Center for Practical Bioethics that gives detailed information for those going through the advanced planning process.

Putting your advance directives in writing is a great first step, but don’t stop there. It’s important for individuals and family members to follow up with conversations about the questions and decisions. Just remember, talking about end-of-life issues does not mean discussing how you want to die – it means talking about how you want to live.