The Conversation No One Wants to Have

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Provided by Sentara Northern Virginia Medical Center

What if there’s a terrible car accident, sudden cardiac arrest, or if a serious illness takes a terrible and unexpected turn? Do your loved ones know what you would want if you were unable to tell the medical team at your bedside? Now is the time to talk about your health care wishes.

Talking with your family and physician before you are faced with a medical crisis can be a tremendous gift to your loved ones, and to yourself.

April 16 is recognized as National Healthcare Decisions Day, a time when people are encouraged to talk about their health care priorities and making wishes known. Sentara Northern Virginia Medical Center encourages all adults, regardless of age, to take time this month and talk with those they care about.

Talking about end-of-life wishes can be tough for the person initiating the conversation… and equally uncomfortable for the person on the receiving end. However, these conversations help create an understanding of what matters most to you during the final phase of your life, whenever that might be.

“An advance care plan protects your rights to make decisions about your own medical care, even when you are too sick or injured to make your wishes known,” says Rev. Dr. Ruth Anne Sawyer, Chaplaincy Services and Decedent Affairs and Ethics Consultant at Sentara Northern Virginia Medical Center. “Advance care planning is for everyone. At any age, a medical crisis could leave you unable to communicate your own health care decisions. Planning now for your future health care can help ensure you get the medical care you want and that someone you trust will be there to make decisions for you.”

If you don’t know where to start, write down your thoughts as a foundation for the talk you need to have with your loved ones.

It may be helpful to ask yourself the question: If I were diagnosed with a life limiting illness, what types of treatment would you prefer? More importantly, what don’t you want?

How would you like your choices honored at the end of life? For example, where would you like to get care? In your home, a nursing facility, a hospital?

What kinds of aggressive treatment would you want or not want? Resuscitation if your heart stops, a breathing machine, or a feeding tube?

Once you’ve thought about these very personal decisions, it’s important to complete a document such as an advance directive or living will which describes your wishes and specifies which medical treatments you want – or you don’t want – if you’re faced with a medical crisis or terminal illness.

Have you named someone to make decisions on your behalf if you became unable to do so?

Identifying the person to speak on your behalf if you cannot is done with a document often called a health care proxy or health care power of attorney.

Having these thoughtful conversations with those you care about and with your health care providers, completing documents like an advance directive and a health care proxy, these are all part of Advance Care Planning.

Planning for the care you would want in advance of facing a serious, life-threatening situation can guide and simplify the choices you or your loved ones must make at a time of medical crisis.

So, make time to TALK:

  • Take time to have the conversation with your loved ones and your care providers.
  • Always be open and honest.
  • Leave no doubt about your values and preferences.
  • Keep your documents up to date and available.

People cope with end-of-life issues in different ways and the decisions they make are very personal. It can be difficult to have these conversations at first, but many people find peace of mind once they’ve done it.

Sentara has an Advance Care Planning Guide that’s available online at that can guide your discussions and help with documenting your wishes. Download Sentara’s Virginia Advance Care Planning (ACP) Guide in English or Spanish, free of charge at


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