12 Tips for End-of-Life Communication and Decision Making

End-of-Life Communication and Decision Making

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The purpose of end-of-life (EOL) communication and decision-making is to establish a common understanding of a person’s values and preferences for treatment that create a plan for care that is in accordance with these beliefs and values. Enhancing the communication and decision-making process during the EOL is an important issue from the patient’s and family’s perspective.

Enhancing the communication and decision-making process in the last days of life (EOL) is of top importance from a patient’s and family’s perspective. The primary objective for EOL communication and decision-making is to develop a shared knowledge of the person’s beliefs and preferences in regard to care that create a plan for care that is in line with the values and preferences of these individuals. In EOL circumstances, the majority of patients are not able to make these decisions. Still, patients involved through advanced health plans (ACP) have a higher chance of receiving treatment that reflects the patient’s preferences. ACP is linked to greater quality of life, more satisfaction with care for patients, as well as lower rates of anxiety and depression among bereaved family members, and significantly less costs for healthcare costs.4 As such, healthcare organizations worldwide have adopted policies regarding ACP. To succeed, the decisions made as part of ACP should be made available for patients with serious illnesses. ACP is often not accessible or requested, an opportunity lost to improve the quality of care provided to EOL patients. 

There is still a significant gap regarding EOL communication, and decision-making for elderly, sick patients admitted into acute health care institutions. Lack of discussions or documentation of the purpose of treatment is a mistake of omission. It frequently leads to more invasive treatment than is sought by the patient. Improved communication and decision-making can be used not only to improve patient care and decrease harm but also to reduce the cost of health care. A few health organizations can measure how well they generally provide EOL care, specifically aspects of EOL communication and decision-making. Although a lot of work has been done to establish quality indicators within the vast EOL/palliative care field, we have not found the existence of any quality measures that are species that are specifically related to EOL communication and decision-making.

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End-of-life communication best practices are guidelines that can help individuals and their loved ones navigate this difficult time. They involve open, honest communication between patients, families, and healthcare providers to ensure their wishes are respected, and their end-of-life needs are met.

This blog will discuss some of the best practices for end-of-life communication.

Start the Conversation Early.

It is essential to begin discussing end-of-life care and preferences as soon as possible, even if the person is healthy. Starting the conversation early can help individuals and their loved ones become more comfortable discussing the topic and can ensure that everyone is on the same page about the person’s end-of-life care wishes. Early conversation allows patients and their families’ ample time to consider all available options and make informed decisions about their care.

Choose a Comfortable and Private Setting.

Having end-of-life care conversations in a private and comfortable setting can make everyone involved feel more at ease. Choose a quiet place with no interruptions, and everyone can speak freely.

Listen Carefully and Empathetically.

When discussing end-of-life care, listening carefully and empathetically to the person’s wishes and concerns is crucial. Allowing the person to express their thoughts and feelings without judgment or interruption is important. End-of-life communication involves active listening by healthcare providers. They should listen to patients and family members carefully, respond to their concerns and questions, and help them understand available options.

Respect the Person’s Wishes.

It is essential to respect the person’s end-of-life care wishes, even if they differ from yours. It is important to remember that the person’s end-of-life care decisions are about their life, not yours.

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Consider Involving a Healthcare Provider.

Healthcare providers, such as physicians, nurses, and social workers, can provide valuable information and guidance on end-of-life care options. They can also help facilitate discussions between the patient and their loved ones.

Be Honest and Direct.

Healthcare providers should be honest and direct with patients and their families about the prognosis and what to expect in the coming days, weeks, and months. It is important to have a clear plan for end-of-life care, including who will make decisions if the person cannot do so, what treatments the person does and does not want, and how the person wants to be cared for at the end of their life. 

Revisit the Conversation Regularly.

As circumstances change, it is important to revisit end-of-life care conversations regularly. This can help ensure that the person’s wishes are respected and that their end-of-life care plan is up-to-date.

Use Plain Language.

Healthcare providers should use simple, easy-to-understand language when discussing end-of-life care with patients and their families. It can help avoid confusion and misunderstandings.

Respect Cultural and Religious Beliefs

Healthcare providers should be aware of and sensitive to cultural and religious beliefs when discussing end-of-life care with patients and their families.

Advocate for the Patient 

Healthcare providers should advocate for their patients’ wishes and ensure they are respected and adhered to. They should also help patients and their families understand the benefits and risks of different treatment options.

Provide Emotional Support: 

End-of-life care can be emotionally challenging for patients and their families. Healthcare providers should offer emotional support and comfort and connect patients and families to resources such as counseling or support groups.

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Encourage Advanced Care Planning

Advanced care planning allows patients to make informed decisions about their care preferences near the end of their life, which can help ensure their wishes are respected. Healthcare providers should encourage advanced care planning and assist in the process.


End-of-life communication is a crucial aspect of care for seriously ill patients. Healthcare providers should use best practices such as starting the conversation early, being honest and direct, using plain language, listening actively, respecting cultural and religious beliefs, advocating for the patient, providing emotional support, and encouraging advanced care planning. These practices ensure that patients are able to make informed decisions about their care and receive the support they need.

Discussing end-of-life care can be a challenging but necessary conversation to have. By starting the conversation early, listening carefully and empathetically, and having a clear plan, individuals and their loved ones can ensure that the person’s end-of-life care wishes are respected and that they receive the care they desire.

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