At Partners In Care in Central Oregon, we understand how deeply personal and sensitive it is to talk about the future—especially when that future involves illness, decline, or the end of life. Whether you’re facing a recent diagnosis or simply thinking ahead, these conversations are not easy—but they are essential.
Advance care planning, palliative care, and end-of-life decisions may feel uncomfortable to discuss, but avoiding them can lead to confusion, stress, and decisions that may not reflect your values or wishes. Talking openly with your loved ones today can provide clarity, empowerment, and peace for tomorrow.
This post offers a thoughtful, compassionate roadmap to help make these important conversations easier, more productive, and centered on what matters most—your values and your family’s well-being.
Why Advance Care Conversations Matter
According to the National Institute on Aging, people who have made advance care plans are far more likely to receive the care they want—and avoid treatments they do not—at the end of life. But even more than that, families who engage in these conversations often report feeling more prepared, less anxious, and less burdened by difficult decisions when a crisis arises.
When you talk about your wishes openly, you remove doubt and guilt from your loved ones. Instead of wondering, “What would they want?” your family can feel confident knowing they’re honoring your values.
Understanding Key Terms
Before you talk, it’s helpful to understand these important concepts:
Advance Care Planning (ACP): A process of reflecting on your health care goals, values, and preferences and making decisions for future care if you’re unable to speak for yourself. This includes naming a health care proxy (someone who will make decisions for you) and completing documents such as a living will or POLST.
Palliative Care: Specialized medical care that focuses on providing relief from the symptoms and stress of serious illness. Palliative care is appropriate at any stage of illness and can be provided alongside curative treatments.
Hospice Care: A form of palliative care provided when curative treatment is no longer the goal, typically for those with a prognosis of six months or less to live. Hospice prioritizes comfort, dignity, and quality of life, usually in the patient’s home or a homelike setting.
Why Families Avoid These Conversations (and Why They Shouldn’t)
Many people hesitate to talk about end-of-life preferences because they fear causing distress or sadness. But silence can have greater consequences—leaving family members unprepared, overwhelmed, and uncertain in a crisis.
Common fears include:
- “It will upset my children or spouse.”
- “It’s bad luck to talk about death.”
- “I’m not sick enough to plan for this yet.”
These conversations are an incredible gift—bringing peace of mind, reducing future anxiety, and ensuring your wishes are respected. Talking early and openly—long before a health crisis—makes the process easier and allows space for thoughtful decisions.
A Step-By-Step Approach to Having the Conversation
At Partners In Care, we recommend this gentle, structured approach, based on best practices from ACP Decisions and Yale Medicine:
1. Choose the Right Moment and Setting
- Pick a quiet, relaxed environment—perhaps during a family meal or a walk.
- Avoid starting the conversation during a crisis or hospital stay if possible.
- Begin with curiosity, not fear:
“I’ve been thinking about the kind of care I’d want if something happened to me. Can we talk about it together?”
2. Share Your Own Thoughts First
- Lead with your values—not medical terms.
“For me, staying independent is important. If I couldn’t care for myself or communicate, I’d want comfort-focused care.”
- Use “I” statements to reduce defensiveness:
“I want you to feel prepared to make decisions if I can’t speak for myself someday.”
3. Ask Open Questions
Help your loved ones express their wishes, too:
- “What matters most to you if you were seriously ill?”
- “Have you thought about who you’d want to make medical decisions if you couldn’t?”
- “Would you want to be in a hospital or at home if you were at the end of life?”
4. Discuss Specific Scenarios
Introduce realistic possibilities gently:
- “If you had advanced dementia and couldn’t recognize family, would you want doctors to use machines to keep you alive?”
- “If you couldn’t breathe without a ventilator, what would you want us to do?”
5. Address Emotions with Compassion
It’s normal for tears, fear, or discomfort to arise. Stay gentle and present:
“This is hard to talk about, but it’s important. I’m glad we’re doing this together.”
Allow pauses. Allow quiet. Stay open.
6. Choose and Inform a Health Care Proxy
A health care proxy (also called a surrogate decision-maker or medical power of attorney) is legally empowered to speak for you if you can’t. Make sure this person:
- Understands your wishes clearly.
- Feels comfortable making decisions on your behalf.
- Knows where to find your documents.
7. Document Your Wishes
Complete these key forms:
- Advance Directive or Living Will
- POLST (Physician Orders for Life-Sustaining Treatment)—for people with serious illness.
- Distribute copies to your proxy, doctors, and family.
- Update annually—or after any major life change.
Sample Conversation Starters
- To Parents or Elders:
“Mom, you’ve always been clear about being independent. Have you thought about what kind of care you’d want if you got very sick or couldn’t make decisions?”
- To Spouse or Partner:
“I want you to know my wishes if something ever happens. I don’t want you to have to make hard choices without knowing what I’d want.”
- To Adult Children:
“I’ve filled out my advance directive. Can we sit down so you understand what I want? It would bring me peace to know you’re prepared.”
Common Do’s and Don’ts
✅ Do:
- Speak openly, without fear or shame.
- Use real-life examples.
- Listen carefully—without judgment.
- Revisit the conversation over time.
- Offer support and validation.
❌ Don’t:
- Force the conversation if emotions run too high.
- Use scare tactics.
- Assume others know your wishes without telling them.
- Wait until a crisis happens.
When to Introduce Palliative Care
Palliative care is often misunderstood. Many assume it’s only for end-of-life—but in fact, palliative care can be introduced early, even alongside curative treatment. According to Yale Medicine, early palliative care can improve both the quality and length of life.
Consider palliative care if:
- A serious illness (cancer, COPD, heart failure, dementia) is diagnosed.
- The person is struggling with symptoms—pain, breathlessness, fatigue.
- Emotional, spiritual, or family distress is present.
- Multiple hospitalizations are occurring.
At Partners In Care, our palliative specialists in Central Oregon offer whole-person support—including medical care, counseling, spiritual guidance, and family resources.
Hospice: When and How to Talk About It
Hospice care is appropriate when curative treatments are no longer effective and focus shifts to comfort and dignity. We recommend families consider hospice when:
- A physician estimates a prognosis of six months or less.
- Quality of life becomes more important than extending life.
- Repeated hospital trips are exhausting or unwanted.
Talking about hospice early allows time to explore options and services—not in a rushed or pressured moment.
Partners In Care: Compassionate Care and Support for Every Stage of Life
At Partners In Care, we are here to walk beside you and your family, offering compassionate support at every stage of your health journey. Whether you are facing a serious illness, recovering from surgery, or nearing the end of life, our care is designed to bring comfort, dignity, and peace of mind.
If you or a loved one needs expert medical care at home, our Home Health care team provides skilled nursing, therapy, and rehabilitation services to help you heal safely in familiar surroundings. For those living with serious or chronic illness, our Palliative Care team can ease pain, manage symptoms, and support your emotional and spiritual well-being—whether you are pursuing curative treatment or focusing on quality of life.
When the time comes for end-of-life care, our Hospice services offer compassionate, patient-centered support—either in your home or in our peaceful Hospice House—so you and your family can focus on comfort and connection. We also provide a free Transitions Program to guide you through complex care decisions, insurance questions, and local resources if you are living with a life-limiting condition but not yet ready for hospice.
And because care continues beyond loss, we offer Grief Support services to help you and your family heal, as well as special support for veterans and their families.
At Partners In Care, your values, choices, and comfort always come first. We are here to listen, guide, and care—every step of the way.
Your Care, Your Choice, Your Voice
At Partners In Care, we believe these conversations are acts of love. They clarify your values, protect your autonomy, and spare your family from the burden of guessing.
It’s never “too early” to talk—only too late.
Start today. Keep the dialogue open. Let your care reflect your life, your beliefs, and your peace.
For help starting these conversations, or to schedule a palliative or hospice consultation, reach out to our compassionate care team. We’re here to walk beside you every step of the way.