Written by: Kimberly Bergmann
September 5, 2016 • 0 comments
Talking about death or what you would like or your loved one’s wishes at end of life can be tough. Having these conversations can feel like “giving up” or that you are being negative or sad instead of making happy memories.
At Cypress Hospice, we’ve found the opposite to be true. In fact, the earlier and more often our patients and their families frankly and honestly discuss their wishes, the more opportunity they have to ensure that when they do reach end of life, there is less stress and more peace.
This is not to say these conversations will be easy. But here are five questions* that can help make these talks run a little more smoothly. You can also tailor these questions to ask them directly of your doctor.
- What is my/your understanding of my/your health and condition?
This is a difficult question, because not every end of life situation is fraught with terrible sickness or health issues. It may be that you and your loved ones need to ask this question every few months to gauge how you are feeling.
- What are my/your goals if my/your health worsens?
How long would you like to prolong treatment? Do you want to do whatever it takes or take extreme measures? Or is there a point where you would like to stop and begin palliative care to manage pain or other symptoms? Discuss this question frankly with your doctor, family and loved ones and make sure everyone is aligned with your goals.
- What are my/your fears?
Every person’s fears are different, but some fears might include:
- Being alone during an illness or at end of life
- Being in pain
- Putting family through watching lengthy or extensive treatments
- Not leaving affairs in order
- Not having spiritual comfort
Again, discuss this question honestly with your family, doctor and loved ones. You may be surprised at what scares you about death and what doesn’t. And your answers may help you decide when it’s best to end or prolong treatment, or when it’s time to call in help, like an estate planner or a palliative care specialist.
- What are the trade-offs I/you are willing to make and not make?
If you want to prolong treatment, are you willing to do it in a hospital setting if that’s the only place you can receive it? If you do not want to prolong treatment, are you willing to explore options for pain and symptom management? If you want to be at home in your final days, are you okay not having hospital staff or equipment close by?
There are many trade-offs that you or your loved one may or may not be willing to make. You may even want to take the time to write down what will and will not work for you during an end of life situation. Make your wishes clear to your family, and if necessary, add it to your legal documents.
- What would a good day look like?
As mentioned previously, end of life truly can be a joyful, celebratory time, so imagine what a good (or even great!) day looks like. Even if you or your loved one is struggling with an illness, map out a good day…maybe that good day is a day spent with family, or a day without pain, or a day simply sitting in the sun with a favorite book.
It is possible to have a good day during an end of life situation. It is even possible to have many good days, but it is important to talk about your ideal day with your doctor, family and loved ones. What needs to happen for your good day(s) to come true?
Open communication about this subject can be hard, but it also can lead to better, more joyful life for you and your loved ones.
*These questions come from Dr. Atul Gawande, an expert on aging and living fully and the author of the book, Being Mortal.