How to Talk About Goals of Care with a Loved One—Even When It’s Hard!

If you’re a family member or caregiver, you may be the one encouraging your loved one to talk about their goals of care. These conversations can be emotional and uncertain—but they’re essential. Knowing what your loved one wants (and doesn’t want) helps everyone make better decisions, especially during a health crisis.

It’s not about pushing for a certain outcome. It’s about understanding what matters most to the person at the center of the care.

Here’s how to approach these conversations with care—and how to handle answers you might not be ready for.

Why Start the Conversation Now

Waiting until your loved one is seriously ill or hospitalized makes everything harder. You might be forced to make quick decisions without knowing what they’d actually want. Starting early allows for calm, thoughtful discussions over time. It also helps reduce guilt and conflict among family members when decisions eventually need to be made.

How to Start the Conversation

It doesn’t need to be formal or dramatic. You’re just opening a door. A few ways to begin:

• “I’ve been thinking about how important it is to know what you’d want if you got sick or needed more care. Can we talk about that?”

• “I want to make sure I could speak up for you the way you’d want. Would you be open to sharing your thoughts about future care?”

• “We don’t have to figure everything out right now, but I’d like to start the conversation, so we’re prepared.”

You might also use a recent event—like a friend’s hospitalization or a news story—as a natural opener.

Prepare for Difficult or Unexpected Answers

It’s common to feel unsettled if your loved one says something you didn’t expect—or don’t agree with. Maybe they don’t want aggressive treatment. Maybe they’ve accepted an illness more than you have. That’s hard. Here are three ways to prepare:

1. Expect emotions—yours and theirs. These conversations bring up fear, grief, and sometimes guilt. That’s okay. Let the person speak without rushing to fix or debate. You can say, “That’s hard to hear, but I appreciate you being honest.”

2. Separate your fear from their values. You might want them to “keep fighting,” but they might value quality of life over time. Remember, this is about their wishes—not yours. You can feel your feelings and still respect their decisions.

3. Don’t panic if you disagree. Disagreements don’t mean the conversation failed. You’re planting seeds, building trust, and creating space for more talks. You can always say, “I didn’t expect that, but I want to understand more. Can we talk again soon?”

Keep the Conversation Going

Goals of care aren’t a one-time discussion. Health changes. So do feelings. Check in regularly, and make sure other family members know what your loved one has said. Write things down. Encourage your loved one to share their wishes with their doctor too.

Final Thought

You don’t need to have all the answers or say everything perfectly. Just show up, ask with care, and listen. Even when it’s uncomfortable, these conversations are an act of love—and they can bring clarity and peace when it matters most.

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