Caregiver Support: Talking About End-of-Life Decisions
When your loved one is diagnosed with a life-limiting illness, it
is important to keep communication as clear and direct as possible. Work at
keeping the lines of communication open with your loved one, with his or her
doctor, and with your family. Recognize your family's style of communication.
How did your family communicate before your loved one was diagnosed with this
serious illness? Were you able to communicate freely and openly, or were there
barriers to your communication, such as frequent arguments or a lack of
sharing? If you encounter barriers, consider visiting a counselor to help
resolve difficult issues and to help your family learn some effective ways to
Talk to your loved one and his or her doctor about the
life-limiting diagnosis. Questions to ask the doctor include:
What are the treatment options?
How long do you expect my loved one to live?
you expect to happen with this diagnosis?
What support services are
available to help my family?
Who will oversee and manage my loved
Who do I call if my loved one is having problems, such
Talk to your loved one about his or her wishes. What end-of-life
goals does he or she have? How do these goals compare with yours? If your loved
one has not communicated his or her end-of-life wishes, talk about them now.
Important issues to discuss include:
What type of medical treatment does your loved one want? Is it curative, life-sustaining treatment, or is it care focused on
maintaining comfort and controlling symptoms without curing the
Has a legal document to express these health care
advance directive—been written?
Personal and family goals.
Discuss your loved one's end-of-life goals.
Are there things that need to be done? Are there relationships that need
mending? Allow opportunities for your loved one to talk about his or her life,
to reflect on accomplishments, and to share any regrets.
goals. What do you need to do to be able to say good-bye? Do you share similar
goals with your loved one? Are there goals or desires that you may not be able
to honor? It is important to share your goals with your loved one.
Location of death. Your loved one can die at one
of several locations, including home, a hospital or nursing home, or possibly a
local hospice house. There is no "right" place to die.
Some people want to die at home surrounded
by family members. Hospice services often can help a person be allowed to die
at home. Some people may be reluctant to die at home because they are concerned
about the welfare of their loved ones or they are fearful about not receiving
the medical care necessary to control their symptoms. For more information on hospice
services in your area, see the topic
Where do you
want your loved one to die? You may want him or her at home, where you can help
provide care. What concerns do you have about caring for your loved one at
home? You may be hesitant to have your loved one die at home because you are
concerned about your ability to care for him or her. This is often a concern
for family members who are elderly or who have health problems of their own.
You may be reluctant to live in a house in which someone has died.
Funeral plans. Does your loved one want
a funeral or memorial service? Does he or she prefer burial or
What financial support is available to help
you care for your dying loved one? Hospice services are a benefit of many
private health insurance policies. Check your health plan for specific
information about hospice coverage. Also, if you qualify for Medicare benefits,
hospice services are covered through the
Medicare hospice benefit.
When your loved
one dies, will you be able to manage the finances? You may want to meet with an
attorney to discuss financial and estate issues. A social worker from your
local hospital or hospice may be available to provide financial
Caring for a dying loved one can be a rewarding but difficult
experience. Taking care of yourself, letting the person do as much as he or she can, and asking for help are three key tips to help both you and the person you're caring for. Services, such as hospice and support groups, can also provide help. For more information, see the topic Caregiver Tips.
How this information was developed to help you make better health decisions.