Conduct Discussions Early

When caregivers and family members are clear about their loved one’s preferences for treatment in the final stages of life, they are free to devote their energies towards care and compassion.

To ensure that everyone in the family understands the person’s wishes, it’s important for anyone diagnosed with a terminal illness to discuss their feelings with their family before the loss of their decision making capabilities or a medical crisis occurs.

• Early Preparation  – The end of life final stages are eased considerably when conversations regarding accommodation, treatment needs and end of life wishes are held as early as possible. Consideration should be given to the need for living arrangements, specialist palliative care services, spiritual needs etc, before the person’s condition deteriorates markedly.
• Seeking financial and legal advice  –  While the person still maintains their cognitive faculties and decision making capability, they can ease the burden on all concerned by completing legal documents such as a Will, Power of Attorney and an Advance Health Care Directive.  These documents can clearly stipulate a patient’s wishes, so family members are informed in advance about their preferences.

• Communication with family members –   If the above documentation is not available or does not clearly stipulate a primary ‘responsible person’, then you will need to choose a primary decision maker who will manage information and coordinate family involvement and support. Even when families know their loved one’s wishes, implementing decisions for or against sustaining or life-prolonging treatments requires communication and coordination between all concerned.

• End of Life wishes  –  If your loved one did not prepare a Will or Advanced Health Care Directive while still legally competent to do so, you will be required to act on what you know and understand his/her wishes to be. Document a list of conversations and events that illustrate their views, and discuss this with other close family members. To the extent possible, consider treatment, placement and decisions about the final stages of dying, from what you know of the person’s wishes.

• Addressing possible family conflicts  –  Stress and grief resulting from a loved one’s terminal illness can often create conflict between family members. If you are unable to agree on living arrangements, medical treatment, or end of life directives, ask a family doctor, social worker, your minister or palliative care specialist to assist with mediation.