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Communication Helps Ease End-of-Life Decisions

Communication Helps Ease End-of-Life Decisions
Communication Helps Ease End-of-Life Decisions


Duke Health News Duke Health News

When a loved one is diagnosed with a terminal illness, their family and health-care providers sometimes have to make difficult, often heart-wrenching decisions. These decisions determine what will be done about nutrition and resuscitation as death nears and whether extreme measures are to be taken to keep a patient alive.

Even though most families are reluctant to discuss these end-of-life decisions, doing so well ahead of time can save a great deal of pain at the hardest time of all.

Anthony Galanos, M.D., associate professor in the division of geriatric medicine at Duke University Medical Center, says that although we may be uncomfortable talking about end-of-life preferences, discussing them in advance eases the burden on everyone.

"No family is prepared to make decisions when a patient is facing the end of life," he says. "Illness of any severity brings out the best and worst in any family, and end-of-life illness heightens the emotions surrounding all of this.

"When mom or dad has already given directives to their children, both verbally and on paper, it allows the children to support their parent, rather than fight each other about what should be done," Galanos adds. "Conversation and understanding among the various family members allows both for the patient's wishes to be respected and for the family to heal more quickly at such a sad time. Children heal much more quickly because they know they honored their parent's wishes."

Galanos says the best solution is a documented living will or, better yet, a health-care proxy or health-care power of attorney, in which a person is designated to make medical decisions when the patient becomes unable to do so.

"The greatest secret about end-of-life care is that the greatest burden falls on the family and not the patient," Galanos says. "Think about a family with five kids that's presented with a life-or-death situation and who have to make a decision on the spot. That's a formula for catastrophe. So the big piece of advice is: talk about it way before your loved one gets sick, and talk to as many people as possible."

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