Our Final Journey
Let's Talk About It
Tools For Viewing
Let's Talk About It
Section 1 - Assistive Technology
Section 2 - Divorce Issues
Section 3 - Drugs/Medications
Section 4 - Checklist, Documents, Forms
Section 5 - Employment Issues
Section 6 - Estate Planning
Advanced Directives & DNR's
Section 7 - Caregiver Resources
Patient Quality of Life: Should Doctors Guess It?
Incontinence Care
Section 8 - Children Seriously Ill
Children of The Chronically Ill
Siblings of Children with Special Health Needs
Guides To Disability Issues
End Stage Hospital & Home Care
Child With A Serious Illness
Individual Family Service Plan (IFSP)
Camps-Special Needs Children
Children's Wish Foundations
Section 9 - For Kids
Section 10 - Family Resources
Section 11 - Patient Resources
Section 12 - Financial Aids
Section 13 - Insurance
Long Term Care Insurance
Section 14 - Legal
Section 15 - Long Term Care
Section 16 - Symptom Support
Section 17 - End of Life
Section 18 - Funeral Planning
Section 19 - After Death Occurs
Hospice FAQS
Symptom Support
Behavoir Strategies
Ill Person's Feelings
Caregiving & Family Harmony
Caregiver Grief ~Article
End of Life
Comforting A Dying Person
End Stages of Life
When Someone Dies
Funeral Planning
Bereavement Fares and Discounts
Common Bonds of Caregiving
Tips For Helping Your Friend
About me
Free Greeting Cards
Estate Planning Definition
Living & Other Trusts
Wills & Beneficiaries
State Laws On Wills
Conservator~Guardianship Definitions
Insurance Issues
Avoiding Probate
Prescription Drug Program I
Prescription Drug Cards II
Disability & SSDI Insurance Questions
Long Term Care Insurance
Employment Issues
Divorce Issues
State Laws-Statutes
Making A Personal File
Emergency Info Form
Emergency Planning
Health Care Surrogate
Forms, Checklist
Family Resources
Patient Resources
Rehab Tools-Assistive Tech. Categories
State Map-Ombudsman Program
NH Your Rights-Fact Sheets
Nursing Homes and Your Rights - Factsheets for some seriously ill or their caregivers.
Long Term Care-Facts & Rights
State & Federal Resources
Drug Resources
Grief & Sorrow
When death nears - Signs and Symptoms
Some Facts About Artificial Nutrition and Hydration
Things To Consider-Artificial Nutrition and Hydration
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Let's Talk About It
Discussions about care wishes during the end of a life often take place in the hallway of the hospital in the midst of a crisis. 
Decisions for end-of-life care are made under incredible stress. Unfortunately, family members may be making their "best guess" about what a loved one would want for end-of-life care, having never discussed
their desires in advance.

Conversations about our desires for end-of-life care are very un
comfortable for all of us. We are reluctant to think about our own
mortality, and that of our loved ones. Frankly, it hurts to think about it. We feel grief and sadness when we contemplate life without that special person, even if they are with us and healthy.

That fear and sadness is normal.

Avoiding the conversation is our way of protecting ourselves from pain. However, avoiding the conversation when we can so easily have it only postpones the issue, and actually makes it harder on us when we are faced with making care decisions and are unable to have a discussion.

Preparing for your conversations

Ask Permission to discuss this topic:
Asking permission will assure your loved one that you will respect and honor their wishes.

Select the right time and place.
Selecting the right time and place to start this conversation is as important as deciding upon the topics to discuss. 
Here are some hints for setting the right time & place:
  • Pick a compatible time. If your loved one is a morning person, then choosing a time after breakfast might be the best.   Like-wise,  if it is common for you to have conversations around an evening meal, then that time should be selected. Perhaps having this conversation over a glass of wine or evening cup of coffee is best for
    you both.
  • Make sure there are no distractions to interrupt you during this conversation.
  • Be prepared to talk frankly and honestly.
    Know what the options are: 
    Becoming familiar with end-of-life care options available in your community will help you to have a clearer conversation.
    Be a good listener:
    As you start this conversation with your family, you must remember to listen for the wants and needs that your love one expresses. With truthful conversation, empathy and respect, you and your family can come to a better understanding about the choices at the end of life.
  • Five Important Questions:
    Give A Gift To Your Loved Ones
    These are five RAQ's (Rarely Asked Questions) that are a tool to help you open up a discussion on end-of-life issues.

    1. "What kind of care do you want for yourself if you're no longer able to make your wishes known, such as after a stroke or accident?" 
    Perhaps this question might also be phrased as what you might want for yourself. Or you might begin by reflecting upon the care that a friend or relative had received at the end of their life.

    2. "What are your greatest fears when you consider what the journey might be like at the end of life?"
    Or this question might start with yourself first, "My greatest fears when I consider what the journey may be like, are...."

    3. "What do you hope for when you consider what the journey may be like at the end of life?"
    Thinking about and talking about how
    you imagine the last months of life to be helps you and your loved one to create a precious time together.

    4. "If I have a life-threatening illness, such as cancer, and the treatments are only making me sick without curing the cancer, but I know that they give you hope, then how can I stop treatment without you losing hope?"

    5. "These discussions about end of life decisions when we are at that point will probably be very hard.
    How do you think we can give each other the courage to have those compassionate conversations and not feel that we are just giving up?"
    Caring Conversations can bring up some challenging questions such as:
    • What can you do if a loved one wants to hasten death because of intense suffering or the fear of suffering?
    • What if the family doesn't agree with the loved one's wishes at the end of life?
    • When is it the right time to stop trying to cure a disease like cancer if it doesn't seem to be responding to
    • Is there usually pain at the end of life?
    • Who do I talk to about making a living will or advance directive?
    These questions and many others can be answered by calling a Hospice near you.  Their professional staff assists people with such issues every day.
    The information that appears on this page is taken from the Website of Kokua Mau: The Hawaii Center for Improving Care at  the End of Life.  Please visit their website at http://www.kokuamau.org
    Kokau Mau has kindly given their permission to use this article.

    Email Webmaster ~ Jean E. Miller