Having Confident End-of-Life Conversations
'It’s not just about dying well - it’s about living meaningfully, right to the end.'
As allied health professionals, we often find ourselves walking alongside older adults through complex health journeys which are shaped not only by functional decline or clinical diagnoses, but by deeply personal values and wishes.
This places us in a unique position to initiate, support, and normalise conversations about end-of-life care. Yet, for many of us, these conversations can feel daunting, 'Am I overstepping?', 'What if I say the wrong thing?', 'Is this my role?'
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It’s not my scope
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I don’t know what to say
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I don’t want to upset them
While initiating formal advance care planning may sit with other professionals, allied health is essential in everyday palliative care conversations. Conversational moments of curiosity, empathy, and listening can open the door to deeper planning.
You don’t need the perfect words. Start with gentle invitations:
- What do you think about what’s ahead?
- Is there anything you’re worried about that we haven’t talked about?
- What’s important to you right now?
Often, it’s the silence that creates distress. Many older adults are already thinking about death and dying. They may be relieved to speak honestly with someone they trust.
Why these conversations matter
End-of-life conversations matter because they give older adults the opportunity to express their worries and wants. They help allied health professionals deliver the care that reflects what matters most to them in their final stages of life. These conversations may also highlight the need for broader input from the healthcare team.
Tips for meaningful conversations
- Start small, start early. Don’t wait until a crisis. Use your ongoing rapport to gradually explore values, preferences, or fears.
- Follow their lead. Be responsive. If someone raises spiritual concerns, changes in function, or future hopes, these can be gentle entry points.
- Know your team. If a conversation raises complex needs, like family conflict, grief, or legal questions, involve palliative care, GPs, or social workers within the health team.
- Respect culture and diversity. End-of-life preferences are deeply shaped by cultural identity. Take time to ask, not assume.
- Document and share. Brief notes about expressed wishes, goals, or priorities can inform broader care planning and multidisciplinary discussions.
Remember: You don’t need all the answers. You just need to be willing to start the conversation.