It is important to have discussions with your loved ones about their end-of-life plans as this is crucial to ensure their desires and choices are honoured. These conversations are often challenging and emotional, but by having open conversations in a compassionate way, it will help ensure that you understand each other’s priorities. This understanding can ultimately help support someone’s well-being as you are aware of their desired choices, even if they no longer have the capacity to make the decision for themselves.  

This article provides guidance on approaching end-of-life care discussions with empathy and compassion, whilst ensuring that your end-of-life plan represents the things that matter most. 

Establish trust and respect 

When talking about end-of life plans with a loved one, it is important to build trust and respect, approaching any conversations with empathy. During this process, ensure that you acknowledge the emotions and concerns of your loved one. It is useful to create a safe space in which to have this discussion where the person can feel comfortable sharing their thoughts and fears.  

During these conversations, be patient and attentive. It is essential that they have the time they need to express themselves fully. By explaining that their independence is the most important thing and their choices are important, it lays the foundation for a meaningful conversation. 

Take note of healthcare and legal regulations 

Before having conversations about end-of-life plans, it may be useful to consider any legal and health-based regulations that could be relevant. 

This knowledge will help you guide your loved one through the available options and ensure their wishes align with legal requirements.  

Key aspects to consider include: 

  • securing an Enduring Power of Attorney (EPA)  
  • creating an Advance Care Plan (ACP) which outlines any future medical treatment and procedures that a person would like to have when the person loses capacity to make their own decisions.  

Websites such as tō tatou reo, advance care planning provides useful information about these process which can help you and your loved one make informed decisions. You can even create your plan online and include the different elements within this plan.  

Begin advance care planning 

When starting to make end-of-life plans, it is essential to consider advance care planning as part of this process as it documents which health and medical treatments would be preferred. During this planning, you can also nominate a substitute decision maker for the future which can be used if or when someone is unable to make these decisions for themselves.  

We are encouraged to complete an Advance Directive (AD), a legal document that articulates the desired medical treatment and care in situations where an individual becomes unable to communicate their preferences. Advance Directives may relate to decisions about life-sustaining measures such as tube feeding or resuscitation etc. When creating an Advance Directive, ensure that all relevant friends and family members understand the significance of this plan. 

By going through advance care planning, it enables your loved one to record their wishes and helps them feel empowered to make their own decisions with regard to any future medical treatment or care. 

Collaborate with others 

When considering end-of-life care planning, it is important that this process is collaborative,  involving family and friends as well as any healthcare professionals which may provide care during this time. 

It may be useful for your loved one to consult with a GP about treatment options and to gather further information about any medical conditions that your loved one is living with as they may be able to provide referrals to the relevant medical, nursing and allied health professionals. This may support current health needs or it may be something to consider about the future progression of a medical condition. 

By taking a collaborative approach to end-of-life planning, it supports decision-making and helps all of the people involved to be informed about the preferences of your loved one.  

Utilise community support  

In New Zealand, there are a variety of support services within the community that can help individuals as they move towards end-of-life care. Organisations such as Hospice New Zealand can help you find local hospices and palliative care nurses alongside other Allied Health professionals can help maintain quality of life as they can help manage the symptoms often associated with a terminal diagnosis, such as pain, changes in diet/appetite, movement, and supports around the home.  

Additionally, home care providers such as Home Instead can support your loved one in their own home, ensuring comfort and quality of life. 

Whilst undertaking end-of life planning, it is also important to consider any cultural and spiritual beliefs to ensure that funeral plans or death rites reflect the beliefs of the individual and to honour cultural heritage or family traditions. 

Once you have researched the different elements involved in end-of-life planning, you can begin to discuss this with your loved one to understand what their wishes are for the future. It is important to create a written record of these to ensure you can meet their wishes and it helps to provide clarity for all family members and friends. 

It is vital that any conversations about end-of-life care with older relatives are dealt with in a sensitive and respectful way, taking note of the legal and healthcare frameworks in place.  

By fostering trust, actively listening, and considering cultural and spiritual beliefs, you can facilitate discussions that honour your relative’s autonomy and wishes. Engaging in shared decision-making, utilising advance care planning, and exploring available community services can ensure the provision of compassionate care aligned with their preferences.