Online Will Blog

How to Discuss Your Health Care Preferences with Your Doctor and Family

Documenting your healthcare wishes through advance directives is essential—but equally important are the conversations that bring these documents to life. Research consistently shows that meaningful discussions about your healthcare preferences significantly increase the likelihood that your wishes will be honored and reduce stress for your loved ones during difficult times.

Learning how to approach these conversations effectively with both healthcare providers and family members ensures your voice guides your care, even when you cannot speak for yourself.

Why Conversations Matter as Much as Documents

Written advance directives provide crucial legal documentation of your healthcare wishes, but studies published in the Journal of the American Medical Association demonstrate that discussions about these preferences dramatically improve outcomes:

• Healthcare decisions more accurately reflect patient preferences
• Family members experience significantly less anxiety, depression, and post-traumatic stress when making decisions
• Conflict among family members and healthcare teams decreases
• Unwanted treatments occur less frequently
• Overall satisfaction with care increases

The National Institute on Aging emphasizes that without these conversations, even well-crafted documents may be misinterpreted or unavailable when needed. Discussions provide context, nuance, and understanding that paper documents alone cannot convey.

Starting the Conversation with Your Doctor

Many people feel hesitant to initiate advance care planning conversations with their healthcare providers. These strategies can help overcome this reluctance:

Choose the Right Time: Schedule a dedicated appointment specifically for advance care planning. Some physicians offer extended visits for this purpose, and Medicare now covers these discussions.

Prepare Specific Questions: Consider questions like:

• "What should I know about advance directives given my specific health conditions?"
• "What medical scenarios would be most important for me to address in my planning?"
• "How do I ensure my advance directives will be followed in different healthcare settings?"

Bring Documentation: If you've already created advance directives, bring them for review and discussion. If not, ask about recommended forms for your jurisdiction.

Request Documentation in Your Medical Record: Ask that your conversation and any completed directives be documented in your medical record.

Involve Your Healthcare Agent: If possible, include your designated healthcare agent in at least one conversation with your physician.

Research shows that healthcare providers welcome these discussions but often wait for patients to initiate them. Taking the first step opens valuable ongoing dialogue about your care preferences.

Evaheld offers preparation guides for these crucial medical conversations, helping you communicate your preferences effectively and ensure they're properly documented in your medical records.

Approaching Family Conversations with Sensitivity

Discussing future healthcare needs with family members can feel uncomfortable initially. These approaches can help create productive, positive conversations:

Choose an Appropriate Setting: Find a comfortable, private space without time pressure or distractions.

Frame Positively: Present the conversation as an act of care and love: "I want to make sure you never have to guess what I would want."

Start with Values: Begin with your general approach to healthcare and quality of life before discussing specific medical scenarios.

Use Conversation Starters: Consider prompts like:

• "I was thinking about what happened to [family member/friend], and it made me want to talk about my own wishes..."
• "I've been working on my advance directives and would like to share my thinking with you..."
• "I just read an article about healthcare planning and realized we've never discussed these things..."

Acknowledge Emotions: Recognize that these discussions may evoke strong feelings. Allow space for emotional responses without becoming defensive.

Make It Ongoing: Present this as the first of several conversations rather than a one-time discussion.

The Conversation Project provides excellent resources for initiating these family discussions with compassion and clarity.

What Your Doctor Needs to Know

Effective discussions with healthcare providers should address several key areas:

Your Overall Healthcare Philosophy: Share your general approach to medical care—whether you typically prefer aggressive treatment, minimal intervention, or something in between.

Quality of Life Considerations: Explain what makes life meaningful to you and what conditions would make life unacceptable from your perspective.

Specific Treatment Preferences: Discuss your wishes regarding:

• Cardiopulmonary resuscitation (CPR)
• Mechanical ventilation
• Artificial nutrition and hydration
• Dialysis
• Antibiotics and other interventions
• Pain management priorities

Religious or Cultural Considerations: Share any spiritual beliefs or cultural practices that should inform your care.

Who Speaks for You: Clearly identify your legally designated healthcare agent and ensure their contact information is in your medical record.

The Centers for Disease Control and Prevention emphasizes that healthcare providers need this comprehensive understanding to provide care aligned with your wishes during critical situations.

What Your Family Needs to Understand

Family conversations should cover different territory than medical discussions, focusing on:

Your Values and Priorities: Help family members understand what quality of life means to you and how these values inform your medical choices.

Reasoning Behind Choices: Explain why you've made certain decisions, especially those that might surprise family members.

Who Has Legal Authority: Clearly communicate who you've designated as your healthcare agent and why you've chosen this person.

Where to Find Documents: Ensure family members know where your advance directives are stored and how to access them.

Specific Requests: Share any particular wishes regarding visitors, personal care preferences, music, readings, or other comfort measures.

Permission to Let Go: Many healthcare agents struggle with guilt when implementing end-of-life decisions. Explicitly giving "permission" to follow your directives even when difficult can provide important emotional support.

The team at Evaheld can help facilitate these important family conversations, providing discussion guides and resources for communicating effectively about these sensitive but critical topics.

Addressing Common Challenges in These Conversations

Several challenges frequently arise during healthcare preference discussions:

Family Resistance: Some family members may be uncomfortable discussing these topics. Approach gently but persistently, perhaps starting with broader values before specific medical scenarios.

Disagreement Among Family Members: Acknowledge different perspectives respectfully while clarifying that your designated agent has legal authority to implement your wishes.

Cultural or Religious Considerations: In some cultures, discussions about future medical needs may be considered inappropriate or unlucky. Find culturally appropriate ways to address necessary planning.

Changing Preferences: Recognize that your wishes may evolve over time. Present these conversations as ongoing discussions rather than one-time decisions.

Finding the Right Words: Many people struggle with terminology. Resources from healthcare organizations provide accessible language for discussing complex medical concepts.

Evaheld provides specialized conversation guides that address these common challenges, helping you navigate these discussions effectively regardless of your family dynamics.

Documenting Conversations and Revisiting Regularly

Healthcare preference discussions should not be one-time events. Create a process for documenting and revisiting these conversations:

Keep Notes: After significant discussions, document key points shared and questions that arose.

Schedule Regular Reviews: Plan to revisit these conversations after major life events or health changes, and periodically even without such triggers.

Update Documents as Needed: Ensure your written directives reflect any evolution in your thinking that emerges from ongoing conversations.

Share Updates Broadly: When your preferences change, communicate these changes to all relevant parties—healthcare providers, agents, and family members.

Studies show that multiple conversations over time lead to greater understanding and more effective implementation of healthcare wishes than single discussions.

Using Conversation Tools and Resources

Numerous resources exist to facilitate effective healthcare preference discussions:

Conversation Guides: Organizations like The Conversation Project offer structured guides for different types of advance care planning discussions.

Values Clarification Tools: These exercises help identify and articulate your priorities before conversations begin.

Letter Templates: Sample letters explaining your healthcare wishes can supplement formal legal documents with more personal communication.

Video Recording Options: Some people choose to create video messages explaining their wishes in their own words.

Professional Facilitators: In complex family situations, healthcare providers, social workers, or clergy can help facilitate productive discussions.

Evaheld's comprehensive planning resources include many of these tools, helping you communicate your preferences clearly and effectively to those who need to understand them.

Conclusion

Meaningful conversations about your healthcare preferences represent an essential complement to written advance directives. Through thoughtful discussions with healthcare providers and loved ones, you create understanding that goes beyond legal documents to encompass your values, priorities, and unique perspective.

While initiating these conversations may feel challenging, the benefits are profound: increased likelihood your wishes will be honored, reduced burden on loved ones, and greater peace of mind knowing those who matter most understand what matters most to you.

Remember that effective healthcare planning combines proper documentation with ongoing communication about your wishes. With support from platforms like Evaheld, you can navigate these important conversations with confidence, ensuring your voice guides your care in any circumstance.