Discovering Your Loved One's Wishes: A Conversation Guide

When faced with difficult health or end-of-life decisions for our loved ones, having a clear understanding of their preferences is invaluable. Unfortunately, many families find themselves making these critical decisions without knowing what their loved ones would have wanted. This guide is designed to help you have meaningful conversations about personal care preferences before a crisis occurs. Through thoughtful, open-ended questions and values exploration, you can document your loved one's wishes while respecting their autonomy and dignity. These conversations, while sometimes challenging to initiate, can provide immense peace of mind and ensure that future care decisions truly reflect your loved one's desires.

Before the Conversation

Preparation Checklist

• Research advance care planning resources and options available in your region

• Choose a quiet, comfortable, and private setting for the conversation

• Select a time when you and your loved one are both relaxed and not rushed

• Consider who else should be present (other family members, trusted friends)

• Bring any relevant documents (healthcare proxy forms, living will templates)

• Prepare yourself emotionally for potentially difficult topics

• Have a notebook ready to document important points

Mindset Reminders

• This is a conversation, not a confrontation

• Listen more than you speak

• Respect your loved one's agency in decision-making

• Be patient - this may require multiple conversations

• Approach with curiosity, not assumptions

• There are no right or wrong answers to these questions

• This conversation demonstrates care, not disrespect

• Focus on understanding, not convincing

• Acknowledge that preferences may change over time

Starting the Conversation

Opening Approaches

• Connect to a recent experience: "After what happened with Uncle Jim, I realized we've never talked about what you would want in a similar situation."

  
  

• Share an article or story: "I read something recently about advance care planning that made me think..."

  
  

• Reference your own planning: "I've been thinking about my own wishes if I ever became seriously ill, and I wondered about yours."

  
  

• Acknowledge the difficulty: "I know this isn't easy to talk about, but I want to make sure I understand what matters most to you."

  
  

• Frame it as a gift: "Knowing your wishes would be a tremendous gift to me if I ever needed to make decisions on your behalf."

  
  

Conversation Starters

• "What does a good day look like for you at this stage of your life?"

  
  

• "Have you ever thought about what would be important to you if you faced a serious health challenge?"

  
  

• "If you couldn't speak for yourself, what would you want me to know about your wishes?"

  
  

• "What experiences have you had with others' serious illnesses that have shaped your thinking?"

  
  

• "What concerns you most when you think about future healthcare decisions?"

  
  

During the Conversation

Effective Communication Strategies

• Ask open-ended questions that can't be answered with just "yes" or "no"

• Practice reflective listening ("So what I'm hearing is...")

• Acknowledge emotions without judgment

• Use silence effectively - give them time to process and respond

• Avoid interrupting or filling uncomfortable silences

• Take breaks if the conversation becomes too emotional

• Focus on values and quality of life rather than specific medical procedures

• Ask for concrete examples to clarify abstract preferences

• Summarize periodically to ensure understanding

• Document key points during or immediately after the conversation

Addressing Common Concerns

If they say...	You might respond...
"Why are we talking about this? I'm not dying."	"You're right, and I hope we have many more years together. This is about making sure I understand what matters to you most if circumstances change."
"You'll know what to do when the time comes."	"I want to honor your wishes, but making these decisions can be incredibly difficult without guidance. Even a few insights from you would help me feel more confident."
"I don't want to be a burden to anyone."	"You could never be a burden. Understanding your wishes actually helps us all feel less burdened by uncertainty if difficult decisions need to be made."
"This is too depressing to talk about."	"I understand it's not easy. We don't need to figure everything out today. Even small conversations help. Would it be easier to start with what brings you joy?"
"Let's just let nature take its course."	"That's an important perspective. Can you help me understand what 'letting nature take its course' means to you specifically?"
"I just want the doctors to do everything possible."	"That's helpful to know. Can you tell me more about what 'everything possible' means to you? What outcomes would be most important?"
"I've already told your sister about this."	"I'm glad you've spoken with her. It would help me to hear directly from you too, so we're all on the same page."
"I've already written it all down somewhere."	"That's wonderful! Could we review those documents together so I can ask any questions and make sure I understand everything correctly?"

Moving Forward

Next Steps to Suggest

• Document the conversation in writing while it's fresh

• Consider formalizing wishes through advance directives

• Share decisions with other family members and healthcare providers

• Schedule regular reviews of preferences (annually or after major life events)

• Discuss specific healthcare proxy designation

• Explore resources for additional guidance (local elder law attorneys, hospital advance care planning programs)

• Identify gaps in the conversation to address in future discussions

• Create a clear location for important documents that everyone knows about

Following Up

• Express gratitude for their openness

• Acknowledge that preferences may evolve and conversations can continue

• Set a specific time to follow up (rather than leaving it open-ended)

• Share what you learned and what was meaningful to you

• Provide them with any requested information or resources

• Consider sending a thoughtful note reflecting on the conversation

• Look for natural opportunities to continue the dialogue in everyday moments

Sample Dialogue

Adult Child: Mom, I've been thinking about something important lately. After what happened with Aunt Sarah last year, when nobody knew what treatments she would have wanted, it made me realize we've never really talked about your wishes if you were ever in a serious medical situation. Would you be open to talking about that a bit?

Parent: Oh goodness, why are you thinking about such gloomy things? I'm perfectly healthy!

Adult Child: You're right, and I'm so grateful for your good health. This isn't about expecting anything bad to happen soon. It's more about giving me peace of mind that if I ever needed to help make decisions, I'd have a good understanding of what matters most to you. Even just sharing a few thoughts would be really helpful.

Parent: Well, I suppose that makes sense. I wouldn't want you kids arguing about what I would have wanted like Sarah's children did.

Adult Child: Exactly. So maybe we could start with something simple: When you think about what makes life meaningful for you, what comes to mind? What activities or experiences would be essential for your quality of life?

Parent: That's a big question. I suppose being able to spend time with family is number one. And I've always valued my independence. I wouldn't want to be kept alive if I couldn't recognize you or make my own decisions anymore.

Adult Child: Thank you for sharing that. It helps me understand what's important to you. So relationships and cognitive awareness are priorities. Would you be comfortable if we talked a bit more specifically about certain medical situations, like if you needed life support?

Parent: I think I'd need to know more about what that means exactly. I wouldn't want to be kept alive by machines indefinitely, but I also wouldn't want to give up too soon if there was a real chance of recovery.

Adult Child: That's a really thoughtful perspective. It sounds like you'd be open to temporary life-supporting measures if there was a meaningful chance of recovery, but not indefinite support with little hope of improvement. Does that capture your thinking correctly?

Parent: Yes, that's it exactly. And I'd want you children to be able to move forward with your lives, not stuck visiting me in a hospital for years if I wasn't really "there" anymore.

Adult Child: I appreciate your clarity on that. This is exactly the kind of guidance that would help us honor your wishes. Would it be okay if I wrote some of this down, and maybe we could look at an advance directive form together next week? These documents can help formalize your preferences.

Parent: I think that would be a good idea. I've actually thought about this more than you might realize. I just didn't know how to bring it up.

Adult Child: I'm so glad we're talking about it now. And we don't have to figure everything out today. This can be an ongoing conversation. Thank you for being open to discussing this with me—it really means a lot.