How to Talk to Healthcare Providers About End-of-Life Wishes

One of the most important conversations you can have with your loved ones is to share your thoughts and feelings about the end of your life. The people closest to you need to know what you want for your last days so that they can advocate for your wishes, if you, for any reason, are unable to speak for yourself. This vital conversation could help you avoid receiving futile and expensive care that you don't want. But talking with your personal healthcare professional about your feelings and wishes is also essential. Your provider may be part of the medical decision-making team at the end of your life and will need to know, in alignment with your loved ones, what choices you would make for yourself. In addition, your medical practitioner can offer you valuable advice about your current state of health and the tough decisions you may need to face in the future. Here are seven tips for taking to healthcare providers about your end-of-life wishes:

1. Don't wait for your provider to bring it up.

You will most likely need to initiate this end-of-life discussion. Even though there is a current movement to encourage doctors to have these conversations by providing Medicare payment, studies have shown that only about 14 percent of physicians are engaging in advance care planning discussions with their patients. So your care provider might be one of those who are reluctant to start the process.

2. Schedule a dedicated appointment for the conversation.

Medical office visits for chronic health issues tend to be filled with many necessary tasks like arranging for lab tests, prescription renewals, and specialty referrals. Your doctor is likely to feel too rushed to have this important discussion in the middle of managing your hypertension or other health concern. So to allow enough time for a more relaxed discussion you should schedule a separate visit. Tell the receptionist that it is for advance care planning and ask for at least a 30-minute appointment. It may be necessary to reinforce that you have some important health-related issues to discuss with your provider.

3. Be prepared.

Your visit with your healthcare provider will be much more productive and gratifying if you have prepared in advance. Spend some time learning about the options available at the end-of-life and thinking about your own preferences. The Conversation Starter Kit is a great place to begin. Download and print the free kit and complete it before your appointment. Go through each of the questions and take your time responding thoughtfully.

4. Choose your healthcare proxy.

Decide in advance who you would want to speak on your behalf if you are unable to express your own wishes. Remember to choose someone who will be able to handle that responsibility emotionally and who also will be able to agree with your choices. Speak to that person and make sure they are willing to fulfill this role before your appointment. Also be prepared to name two people as alternates.

5. Print your paperwork in advance.

Your state of residence will have specific forms you will need to complete, usually called the Living Will and the Healthcare Proxy form (or Durable Medical Power of Attorney), though your state may use different terminology. This is the official paperwork your provider will help you complete, so you can save a lot of time if you bring it with you to your appointment.

6. Bring a list of your questions.

As you review the advance directive forms and the Conversation Starter Kit, write down any questions that come up for you. Ask about your own health status and what you can expect in the future. You also might have questions about some of the terms used in your advance directive forms, like mechanical ventilation, artificial nutrition and CPR.

7. Schedule a follow-up visit if necessary.

These are complex conversations to have and difficult decisions to make so don't hesitate to return to your provider's office for more discussion if necessary. It's important that your wishes be clarified and understood so take all the time you need to accomplish that. Also it is recommended that you revisit your choices and update your paperwork every 5 years or whenever your health status changes. Planning ahead for the end-of-life is an ongoing process rather than a one-time task, so be prepared to have multiple conversations in the future. People who have completed their advance directives say they feel more at peace and comfortable about the future. Get your own planning started now so that you too can rest easy and live your life with less fear.