Discussing the final months, weeks and eventually moments of your life is a topic many prefer to avoid, but it’s best to have that conversation now - before it is too late.
For patients who have a chronic condition that is life-limiting, the importance of talking to loved ones and healthcare professionals about what they want for their final days and when they die can’t be underestimated.
Having frank and honest conversations in the months and weeks leading up to the end of their life offers people a safe opportunity to share their requests for the last stage of their life. That could focus on the treatment options that might be best for that individual, or it may be centred around religious, spiritual or social needs.
It can lead to an improvement in the end-of-life care provided and reduce the burden on families or close friends. It often relieves anxiety - as relatives won't have to make decisions on behalf of their loved one, worrying about what to do for the best.
It can also avoid unwanted or futile invasive treatments, offering people a more peaceful way to die. Knowing that in advance could help a person decide against going into hospital and instead have their care at home in a familiar environment with family and friends around them.
Talking about this early allows people to have the four conversations that are universally important to people who are dying – thank you; forgive me; I forgive you; I love you.
Each person’s needs may differ, but the focus is the same – what matters to them.
This involves recognising patients who are coming to the end of their life at the earliest possible stage, and generating conversations earlier so their wishes are discussed, recorded and respected.
The sooner this is highlighted the more time it gives the patient, family members and healthcare professionals the opportunity to put things in place.
It is important that people who are closest to the patient also have these conversations early on to help provide a less complicated bereavement period.
So when is the right time to talk to patients, and who should talk to them?
The stages of a patient with a progressive chronic condition is split into four parts:
1. After diagnosis, when the condition is often responsive to treatments
2. When medications require some fine tuning or additional medications
3. Condition is not responding to treatment - this often leads to more hospital admissions
4. Last days of life
It is after the first stage when any healthcare professional – ranging from a GP, care home staff and consultant to occupational therapist or nurse – should talk to the patient.
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