How to Talk About Death: Navigating End-of-Life Care and Conversations

Many people have strong opinions about how they feel about resuscitation, but don’t initiate an end-of-life discussion beyond that narrow focus. But understanding your loved one’s wishes toward the end of life and after death cannot only make the transition smoother for both of you, but also offer peace of mind when you worry you may not be handling things how they’d want you to. Having these discussions can feel uncomfortable, but using good communication to address the wide range of concerns that dying loved ones undoubtedly face can bring a lot of peace – even if that feels counterintuitive.

Topics like:

Fears about dying
Achieving end-of-life goals
Understanding their prognosis
Addressing physical, emotional, or religious needs as the end draws nearer
And understanding postmortem wishes

Can be an important part of their treatment plan.

In this article, we hope to help you talk about death comfortably. How to establish strong communication to reduce fears on both sides, minimize pain and confusion, and resolve any potential conflicts amicably and comfortably, confident you know your loved one’s wishes. Let’s dive in.

How to Discuss Death: Understanding End-of-Life Care Options

Families and medical care teams alike struggle to initiate conversations about death. It’s a cultural aversion that is to be expected, but with a bit of preparation, you can handle it with care.

A lot of families feel that death is a failure of the medical system because there’s nothing else a doctor can offer them. This perception is why you may find it hard to have a conversation with a physician on this topic unless you first initiate it. As such, you’ll need to consider how to bring it up both for your loved one so you can better understand their wants and needs, as well as with the physician who can help ensure they’re followed.

Start with Prognosis

The first thing your loved one will need to come to terms with is their prognosis. Understanding what’s happening in their body, what to expect, and how much time they may have, while morbid and often terrifying, can help bring a sense of peace. Avoiding those topics, on the other hand, tends to cause fear and panic when changes happen unexpectedly. This is a conversation best had in the presence of the medical care team.

This discussion will also usually venture into topics like:

A surrogate decision maker
Advanced directives that should be put in place
Resucitation preferences
Outstanding treatment and/or comfort options
Etc.

End-of-Life Personal Goals

Next, touch on any personal goals your loved one may have. With an understanding of what to expect and when to expect it, you can seriously discuss any final wishes, including:

Places they want to go
People they want to see
Letters or messages they want to send
Things they want to do or achieve
Etc.

You can prioritize these goals together based on what you and the medical team discussed and what can reasonably be accomplished.

Sort Out End-of-Life Care Goals

Another discussion you’ll need to have is a discussion about end-of-life goals for care, specifically. Goals could include, for example: passing peacefully, passing with little to no discomfort, or being surrounded by those you love.

“As death nears, most patients share similar goals; maximizing time with family and friends, avoiding hospitalization and unnecessary procedures, maintaining functionality, and minimizing pain.” (Source)

As such, this is usually where a discussion about hospice care preferences would naturally fit.

Hospice Care

Bringing up hospice care, however, can be difficult. There are a lot of fears and misconceptions about what hospice means, and bringing it up may feel like you’re starting a conversation about “giving up.”

Hospice is an end-of-life service that focuses on comfort and quality of life provided in the comfort of your loved one’s own home, wherever that may be. If your loved one has goals like passing at home, passing peacefully, passing with little to no discomfort, etc., hospice is a great option to achieve them.

Post-mortem Goals

Finally, it’s important to get on the same page about what your loved one wishes for after they pass. This could be anything – funeral wishes, cremation preferences, obituary announcement placements, will adjustments, etc.

Having clear discussions about what’s expected before the time comes will give you – the executor of such wishes – clarity and peace of mind when the time comes. There are so many decisions to be made that knowing how to make them can reduce the weight and pressure of each decision at a time when you’re also battling grief. These clarifications can make all the difference.

Closing Thoughts: How to Talk About Death

Get more information about hospice and end-of-life care here. This time period is an incredibly stressful one, for both you and the loved one in your care. You’ll undoubtedly face a lot of questions, and understanding what your loved one wants can put a lot of confidence behind your decisions. Some families struggle with an abundance of personal opinions as the end draws near about how best to handle things, so putting your loved one’s wants and needs first with a direct and empathetic conversation can help you handle these moments with grace and peace.

If you are caring for someone toward the end of their life, we invite you to check out our library resources. The California Caregiver Resource Center is a 501c(3) nonprofit network of 11 Centers covering the entire state of California here to help connect you with medical resources and support in this journey.

To get more information about the resources we have available to you as a California caregiver, contact us at the California Caregiver Resource Center nearest to you or join CareNav for free today.