End-of-Life Care is a Hard Discussion to Have, But a Necessary One

Research shows 90% of people think it’s important to talk to loved ones about end-of-life care, but only a fraction of people have those conversations. In this Tennessean column, Compassus Senior Vice President and Chief Clinical Operations Officer Laura Templeton explains the importance of advance care planning, key issues to address and how to navigate these discussions.

Laura Templeton

Laura Templeton

Talking about the end of our lives may be considered taboo, but it’s an important discussion to have with loved ones.  


In the decade I worked as a practicing nurse, I saw the struggle and grief of families who had to make end-of-life decisions without knowing what their loved ones wanted. It can be traumatizing to guess at these choices, especially following unexpected events. 


Advance care planning is a key part of the end-of-life care experience for patients and their families. That’s why it’s so essential to make these plans before we need them.  

Advance Care Planning

Simply put, advance care planning is planning for care before it becomes too difficult or impossible to make one’s wishes known.  


There are two key parts to advance care planning: conversations with your health care professionals and loved ones, and having your wishes documented in legal documents and medical orders. As you’re creating these documents, some of the issues you may consider include: 


  • Where you want to live out your final days  
  • What, if any, life-supporting measures you want to receive 
  • Who will be the person to carry out your wishes if you cannot communicate 

A recent study found that while 90% of people think it’s important to talk to their loved ones about end of life care issues, only 27% have had those conversations. Most people avoid talking about end-of-life care so they won’t upset their loved ones but, in fact, these conversations can help relieve stress and lead to improved quality of life. 


It’s critical we have these conversations and establish these documents yet recognize it’s not a once-and-done proposition. Having your plans in place, keeping them updated, and discussing their contents can help address loved ones’ greatest concerns about your physical comfort, emotional support and spiritual preferences. 

Getting Started

Fortunately, there are many helpful resources available.


For example, the Conversation Project offers guides and worksheets to facilitate these conversations, which they suggest you begin by asking questions about which parts of life are most meaningful to that person. AARP also has helpful suggestions that can be useful in breaking the ice or getting to the heart of an issue. One prompt about whether you view certain friends or family members’ deaths as “good” or “hard” is particularly thought-provoking. 


If you haven’t made your own advance care plans, consider offering to go through this process with a loved one. You may discover that other family members have already made these plans, giving you an opportunity to understand their decisions so you can support their wishes later. 

What comes next

Regulations about advance care planning and even the names of the documents used vary from state to state. Be sure to identify your state’s requirements and the correct forms. CaringInfo provides free advance directives and instructions for each state. In addition, your physician is a good source of information about how your health history and conditions may factor into end-of-life plans.  


Remember, life can change and so may the treatment you and your loved ones want depending on age, health and other factors. Begin having these conversations now and keep the dialogue going. Don’t wait until it’s too late. 


Laura Templeton is senior vice president and chief clinical operations officer at Compassus. Compassus provides a continuum of home-based services, including home health, infusion therapy, palliative and hospice care in 200 locations across 30 states.