Last week I sat with a patient who wanted to talk about end of life care. They weren’t sure how to bring it up with their family. That’s something I see often. These conversations are difficult, and many families don’t know what their loved one would want until a crisis forces the issue.

In medicine, we routinely ask elderly or terminally ill patients about their preferences if their heart were to stop or they couldn’t breathe. For younger patients the assumption is clear—everything will be done. That usually means putting in a breathing tube, doing CPR, and starting medications through an IV. But for someone at the end of their life, those same measures may not be what they want. Some even feel those interventions would add suffering rather than comfort. What many people don’t realize is that unless there’s a written order stating otherwise, hospitals are required to attempt resuscitation (American Hospital Association, 2008).

Families often find it easier to honor those wishes if they’ve already been discussed. I’ve seen the opposite too—relatives gathered at the bedside, each with a different opinion, unsure of what the patient would have chosen. When these conversations happen in advance, patients get peace of mind and families can act with confidence.

Many hospitals offer worksheets to help guide these decisions. They can be filled out ahead of time and kept in an accessible place, like on the refrigerator. That way, if emergency responders arrive, the document is easy to find. State-specific advance directives were available as early as 2011 through the National Hospice and Palliative Care Organization, and those forms allowed patients to record their choices and designate someone to speak for them if they could not (NHPCO, 2011).

These conversations are never simple, but they make a difference. They help ensure care matches what the patient truly wants and reduce the stress on families in the middle of a crisis.

Scott Rennie, D.O.
Board Certified in Obesity Medicine and Family Medicine

This blog is for educational purposes only and does not constitute individual medical advice. Always consult your own physician before making changes to your health, medications, or treatment plan.

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Sources (pre-2011):

• American Hospital Association. “Patient Self-Determination Act and Advance Directives.” AHA, 2008.

• National Hospice and Palliative Care Organization. “Advance Directives.” NHPCO, 2011.