Talking about… end-of-life planning

Why you might want to talk

Talking about the end of life can be very emotional, both for the person who is nearing the end of their life and for their friends and family. Your friend or relative may avoid talking about it because they:

• don’t want to upset anyone
• are superstitious – they think talking about it will make it happen
• don’t want to be seen as morbid
• assume you know their wishes
• don’t know what their options are.

Don’t assume that you don’t need to have the conversation, for example because they think they don’t have anything to leave in a will, or they have a particular faith so they’ll want to have a certain sort of funeral. It’s easy to overlook things or make wrong assumptions, so it’s good to talk things through to make sure you have a clear understanding of what they want. Discussing things out loud can be helpful for your relative too, as they may be unsure of exactly what they want for themselves.

Talking things through can be a positive experience for both you and your relative or friend. The benefits of talking include:

• they'll feel in control
• they'll have the relief of knowing that their wishes have been documented
• you will know what they want and won't have to worry about getting it wrong
• it helps family to feel involved
• it can avoid stress and disagreement between family members if they have to make decisions on a relative’s behalf or after they’ve died.

How to start the conversation

You might not know how to begin talking about end-of-life planning. Use triggers to introduce the subject – talk about something that’s happened to someone you know, TV programmes or news items. Ask questions that encourage your relative to think about what they truly want:

• How would you feel in that situation?
• Are there any treatments you wouldn’t want?
• Have you thought about writing down what you want?

You don’t have to focus on a worst-case scenario, as this may make your relative feel uncomfortable and sad about the future. Instead, you can frame your questions in a way that focuses on what matters most to them.

For more tips on how to raise the subject, read Compassion in Dying’s guide Starting the conversation.

What to consider

There are many things to consider when planning for the end of life. This might include:

• where your friend or relative wants to be cared for – for example, at home, in a care home or in a hospice – and where they might want to spend the end of their life
• legal and financial matters, such as making a will or setting up a lasting power of attorney for property and financial affairs
• what sort of funeral they would want and how it might be paid for. Our downloadable funeral planner can help them to plan this
• what will happen to their pets.

Your friend or relative’s wishes concerning their care and treatment can be recorded in:

• a lasting power of attorney for health and welfare
• an advance decision, which, if set up correctly, is legally binding and lets your relative specify treatments they wouldn’t want to receive in certain circumstances. For example, they might want to say that if they were in a coma they wouldn’t want CPR if their heart stopped. Advance decisions would be used if your relative lost mental capacity, which is the ability to make and communicate a decision when it needs to be made
• an advance statement, which is a written statement of your wishes for your future care and treatment. It isn’t just about medical treatment – you can also include your preferences on other matters, such as your daily routine and what food you like. It isn’t legally binding but anyone making decisions about your care would have to take it into account if you lost mental capacity.

They may benefit from support from a trained counsellor or organisations that deal with specific long-term conditions.