Talking to an elderly loved one about end of life care is never an easy conversation, but it’s often a necessary one. Despite the fact it can be difficult, there are measures you can take to approach the conversation with tact and care, making sure your loved one’s interests are placed front and center.
Goals and Expectations
“In dealing with hospice and end of life care, the first thing that’s important is that you need to meet [your loved one] where they are,” says Myra Dorris, Licensed Clinical Social Worker at the Visiting Nurse Association of Greater St. Louis (VNA). “One of the first questions I like to lead with is ‘What are your expectations in terms of end of life care?’”
This is one of the most important aspects of the conversation around end of life care: making sure that family and patient goals and expectations are aligned, or at least making sure that a middle ground is decided upon and consented to by your loved one. This includes making sure one’s advanced directives (a legal document that outlines how you want medical decisions to be made if you can’t make them yourself) are in order.
Deciding What Care is Right
The conversation around end of life care needs to include making sure that hospice is the right choice for your loved one. Your loved one’s needs need to be properly evaluated to make sure that they wouldn’t be better suited for palliative care or other treatment. Figuring out where they’re at in that regard means looking at all options thoroughly before deciding on a trajectory.
To help with these conversations, one of the first things VNA does when helping caregivers and their loved ones decide on a plan of action is have an informational meeting with the family. This meeting includes making sure they are actually ready to transition to hospice. It also includes discussing the aforementioned goals and directives to make sure that not only the caregiver and loved one are on the same page but that VNA staff is aware of these goals to provide support as best as they can.
Many times, family members other than the primary caregiver will want to be involved in these conversations. It’s important to keep in mind that grief will always be associated with end of life care, and people cope with this anticipatory grief in different ways. It’s important as a family unit to evaluate what contributions can be made by other family members, be it helping with shopping or giving the primary caregiver breaks, so that they can be included in assisting their loved one even if not directly involved in conversations around the care they’re receiving.
“I think the most important thing is that this is all very much a team effort,” says Myra. “Our nurses, families, chaplains and social workers are all working together toward the same goal: helping patients and families have a positive outcome at the end of life.”
To learn more about our hospice program, visit our website.