A thoughtful, structured conversation about the goals of end of life care must also include a recognition of the life already lived.
The discussion is intended to help ensure that end of life care is consistent with the patient’s values and wishes as well as define care priorities and goals. The goals of care include: longevity (treat everything to prolong life), maintain function (e.g., begin life prolonging treatments, but stop if not working; limit interventions to non invasive care), and palliation (comfort care). Advanced directives are created to plan for future medical decisions when the individual does not have the ability to communicate to understand the consequences of decisions.
In this conversation, there must also be opportunity to understand the life already lived.
Oliver Sacks, noted Professor of Neurology and author, in learning he has terminal cancer, shared his thoughts about his life in the attached essay.
Managed Death in a Pace: Pathways in Present and Advanced Directives Schamp, Tenku J AM Med Dir Assoc. 2006
UPDATE: I am pleased have been invited to facilitate programs at several Westchester libraries and Senior Law Day about family dialogues around aging issues.