Courageous Conversations in End-of-Life Care

The month of November marks the national celebration of both hospice and palliative care programs. It is a time to recognize the excellent care that Hospice and Palliative care teams provide. Still, it is also a great time to spread awareness regarding important issues related to end-of-life decision-making.

NHPCO, the National Hospice and Palliative Care Organization, has identified the theme of this year's recognition month as "Courageous Conversations." Courageous conversations are discussions among family members, friends, relatives, and healthcare team members regarding end-of-life decision-making. Talking about end-of-life decisions may seem odd in a healthcare system defined by interventions and a culture that resists death and dying. However, courageous conversations may prompt discussions that lead families and patients on a path of guidance, support, and inspiration.

Often, when patients' disease trajectories quickly change, decisions must be made in a highly emotional, crisis-type environment.

If family members knew and understood the patient's wishes and desires before the "crisis," decisions would be made with a different state of mind. It would change from "deciding for a loved one" to "honoring the wishes of a loved one." By having these discussions, daughters, sons, spouses, and loved ones remain just that. They can be present in their loved one's life and would not have to be the director of care, the nurse, or any other healthcare role. To be truly present for a loved one in their final months and days, is the greatest gift.

NHPCO encourages conversation and questions such as "What does death mean in my life? If I am faced with a terminal diagnosis, how would my values shape my end-of-life journey? How do I want my loved ones to engage with me toward the end of my life?"

It is difficult to think about these questions, but having these courageous conversations with ourselves, family, friends, and doctors can mean the difference between having the type of death a patient wants – one that matches up with their values and desires – one that doesn't allow them to have a say in their end of life." (NHPCO)

Courageous Conversations allow us all to actively participate in how or what our end-of-life journey may look like. It is a piece that may allow each of us a good death, something everyone deserves.

Laura Marion, RN, BSN, is the Assistant Vice President of Allied Services Hospice and Palliative Care.

About Hospice Care

Allied Services Integrated Health System offers both hospice care services to people throughout Northeastern Pennsylvania. Care is provided in homes, medical facilities, and in our Hospice Centers in Scranton and Wilkes-Barre. For patients who have life-limiting illnesses or health conditions, Allied Services Hospice is committed to delivering the highest standard of care with compassionate attention to the patient’s comfort. We offer expert medical and emotional support, with respect for the wishes of the patient and family.

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