"It is of the utmost importance to respect the principle of patient autonomy, so our loved ones can have the life and death that they envision for themselves."
Q: What are goals of care discussions and why are they important?
A: Goals of care discussions are conversations between patients, their family members, and the healthcare provider about the patient's values, hopes, and goals for their care as they are reaching the end of their life. The most important thing you can do to provide the best care for an elderly or sick family member is to provide the care that your loved one wants. If their condition worsens, it's important to understand if they'd prefer to go to a hospital or remain at home, perhaps under hospice care. It is of the utmost importance to respect the principle of patient autonomy, so our loved ones can have the life and death that they envision for themselves.
Q: How are goals of care discussions helpful for the family members?
A: If there is early and effective communication between a sick family member and the rest of the family, this is much easier. If we know what somebody does (and equally importantly does not) want at the end of life, it takes the guesswork, and the potential for a lot of feelings of guilt, out of the situation. Sometimes the hardest thing to do as a family member is not “do everything”, as doing less than everything possible can feel like a betrayal or disappointment. If we know in advance that our loved one does not want everything, then following their wishes is a gift to them. It takes a huge weight off of a family’s shoulders when these decisions are already made for them by their loved one.
Q: When is the most ideal time to start a goal of care discussion?
A: It is never too early. If you are old enough to have a will, you have probably had to consider what you do and don’t want at the end of life. When you are in your 30s or 40s, the end of life is very abstract, so your views on this may change and evolve as you get older and think more about your mortality. It is always better to think about these issues and make important decisions before there is a health crisis, when you are able to make the decisions for yourself. These can be difficult discussions, but it is best that they are started early.