News & Advice

Initiating Conversations About End-of-Life Preferences and Goals of Care

No one likes to think about their mortality, let alone have difficult discussions about it. However, it’s crucial to have these conversations with your loved ones and healthcare providers to ensure that your wishes regarding end-of-life care are respected and followed. By communicating your preferences and goals of care, you can better prepare yourself and your loved ones for the inevitable.

What are end-of-life preferences and goals of care?

End-of-life preferences refer to the medical treatments and interventions you would like or not like to receive if you are unable to make your own decisions. These could include life-sustaining measures such as CPR, mechanical ventilation, and tube feedings, as well as comfort measures such as pain management and hospice care. Goals of care, on the other hand, are personal and emotional objectives that may inform medical decisions at the end of life. Examples include being able to die at home, being pain-free, or being mentally alert.

Why are these conversations important?

Having conversations about end-of-life preferences and goals of care can help ensure that your wishes are understood and respected by your healthcare providers, family members, and other decision-makers. It can also provide relief to your loved ones by lessening the burden of making difficult choices during a time of crisis or emotional stress. By clarifying your preferences and goals, you can also feel a greater sense of control and peace of mind about the end of your life.

How can I initiate these conversations?

Initiating these conversations can be daunting at first. Here are some tips on how to get started:

  1. Pick the right time and place: Choose a time and place that allows for uninterrupted and private discussion. You might prefer to do it in person, over the phone, or through a video call, depending on your comfort level and location.
  2. Share your motivations: Explain why you want to have this conversation and why it matters to you. You might say something like, “I want us to be on the same page about my care in case something happens to me. I want to make sure that my wishes are respected.”
  3. Ask open-ended questions: Start with open-ended questions to encourage your loved ones to share their thoughts and feelings. Examples include, “What are your thoughts on end-of-life care?” or “What would be most important to you if you were in my situation?”
  4. Be clear and specific: Express your preferences and goals in clear and specific terms. For example, you might say, “I do not wish to receive mechanical ventilation if it will not improve my quality of life” or “I want to be as pain-free as possible, even if that means limiting life-sustaining treatments.”
  5. Listen and be responsive: Remember that these conversations are a two-way street. Listen carefully to your loved ones’ input and be responsive to their concerns and questions. If you have difficulty understanding or expressing your preferences, consider consulting with a healthcare professional or a spiritual counselor for guidance.

Who should I be involved in these conversations?

You should involve anyone who might have a role in your end-of-life care, including family members, close friends, healthcare providers, and legal or financial advisors. While it might be uncomfortable to discuss these topics with certain individuals, it’s important to include everyone who may have a say in your care. This can help avoid confusion and conflicts later on, especially if there are multiple decision-makers with differing opinions.

What if I change my mind?

Keep in mind that end-of-life preferences and goals of care are not set in stone. It’s normal to reevaluate and adjust them as your health status or personal circumstances change over time. It’s important to communicate any changes in your wishes to your loved ones and healthcare providers so that they can adjust their plans accordingly.


Having conversations about end-of-life preferences and goals of care can be emotionally challenging, but it’s an essential step in ensuring that your wishes are respected, and your loved ones are provided with guidance during a time of crisis. By starting the conversation early, being clear and specific, and involving all decision-makers, you can help alleviate uncertainty and ultimately achieve a peaceful and dignified end of life.