Why Have The Conversation

Like most people, you probably feel strongly about your beliefs and desires for end-of-life care. But without The Conversation, your loved ones and health care providers have no way of knowing what it is you want. Often, by the time circumstances require you to have The Conversation, you are unable to make your wishes known. This is why it’s crucial to address end-of-life issues now, rather than waiting for old age, terminal illness, or a major health event to occur.

Communication is the foundation of advance care planning. Having The Conversation with your loved ones and health care providers ensures your treatment will be carried out according to your wishes. It also relieves the stress and anxiety that your loved ones would experience if left to make decisions for your care on their own. In short, it may be one of the most important discussions you ever have.

Read Personal Accounts of Advance Care Planning

When to Have The Conversation

There is no wrong time to have The Conversation with a loved one. However, choosing a favorable setting can go a long way toward establishing healthy communication and creating a positive outcome.

Avoid engaging in The Conversation on a particularly stressful day or a time of day when you’re likely to feel tense. Instead, take advantage of a time when you and your loved one feel calm and open. For some this may mean engaging over a morning cup of coffee–for others, over a meal or when the day is winding down.

Some people find it helpful to take advantage of opportunities that make it feel more natural and less unexpected to bring up end-of-life issues, such as:

  • Death of a family member, friend, or colleague
  • Newspaper articles and TV news stories
  • Books and magazines
  • Movies and TV shows
  • Sermons and other spiritual experiences
  • Family occasions

If you approach a loved one and find s/he isn’t receptive, remember that, no matter how important it is to have an advance care planning discussion, you can’t make that decision for him or her. Plant the seed and patiently wait for another opportunity when s/he might be ready. Whether The Conversation goes smoothly or you stumble through it, keep in mind that it’s not a one-time event. The Conversation is an ongoing discussion that gets revisited regularly on an as-needed basis.

How to Begin The Conversation

When a conversation turns to the topic of death and dying, fear and anxiety can keep you and your loved ones from engaging in the kind of open and honest dialogue that is vital to the advance care planning process. If you are struggling to get comfortable discussing end-of-life issues, it can be helpful to remember that every life, like every story, has a beginning and an end. While we often hear difficult death and dying stories and associate death with negative feelings, not every experience is the same. A “good death” is peaceful, and characterized by respect. Remind yourself that determining, discussing, and documenting your desires for end-of-life care greatly increases the likelihood that the ending to your life’s story will be written the way you want it to be.

Openly sharing your own concerns, feelings, and beliefs about life and death can be helpful in putting your loved ones at ease and allowing them to open up as well. The more comfortable you are when you approach them with the subject, the more likely they are to feel comfortable engaging in The Conversation with you. Encourage discussion by asking open-ended questions and listening empathetically to their responses, whether you share the same views or not. Emotions can run high when you’re having The Conversation. Establishing a safe and respectful environment is the key to a successful interaction.

Ideas to Help You Get the Ball Rolling

  • “I’ve been thinking about the future and how we’ve prepared for so many things. One thing we haven’t talked about is our future health care decisions.”
  • “I was just reading something the other day about the importance of having a plan in place for future medical care. It’s something I’d like to talk about if you’re willing to join me.”
  • “My coworker was telling me about the struggles they’ve been having in caring for his elderly father. His dad never shared with them what kind of medical care he did and didn’t want to receive and now they feel torn about what decisions to make for him. Maybe we should talk about that now so we can be prepared.”
  • “Something in the news yesterday got me thinking. I don’t know what decisions you would want me to make if something happened and you weren’t able to speak for yourself. You might not know what I want either. Chances are we won’t need that information anytime soon, but it’s still a conversation I’d like to have if you’re open to it.”

 Conversation Resources

Have You Had The Conversation?
The Conversation Project

Death and Dying—Patients and Families
Compassion and Support at the End of Life

Conversation Toolkit
Begin The Conversation

Tips for Having A Conversation About End-Of-Life Care
UW Health

Go Wish Cards
Coda Alliance

Advance Care Planning Tip Sheet: Conversation Before Crisis
National Association of Social Workers

Finding Your Way: Talking About End of Life Decisions

Celebrations of Life
Celebrations of Life: Past, Present, and Future

Community Conversations on Compassionate Care
Compassion and Support at the End of Life

Talk to Elderly Patients About the Future
Talk Early Talk Often

Wise Conversations