Talking about what matters most: A quick guide to a goals of care conversation
What is a goals of care conversation?
It is a supportive talk that helps guide medical care based on what matters most to your loved one—now and in the future.
It may include:
- Understanding a person’s values and care preferences
- Planning how to honor their wishes as health needs change
- Creating or updating an advance care plan
- Discussing palliative care or hospice, and when to consider them
- Supporting family members and caregivers through shared decisions
Who can benefit from a goals of care conversation?
- People living with a serious or chronic illness
- Family members or caregivers supporting a loved one with health challenges
- Anyone unsure about how to plan for future medical care
- Those wondering if it may be time to consider hospice
- Individuals who want to understand or express their health care wishes
- Loved ones trying to honor a patient’s values and preferences
How to prepare for the conversation
Before you talk, take a moment to reflect and get ready.
- Ask yourself: What do I hope for in this conversation? Am I ready to listen without judgment?
- Know that it’s normal to feel uncertain or emotional
- Choose a calm, private time, not during a crisis
- Consider starting after a doctor visit or a recent change in health
How to start the conversation
You do not need to have all the right words. What matters most is starting the conversation with care and respect. You might say:
- “I want to make sure we’re making the right choices to keep you most comfortable.”
- “What matters most to you right now?”
- “Have you thought about the kind of care you’d want if you got sicker?”
Things to talk about during a goals of care conversation
- When you think about your health in the coming weeks and months, what’s most important to you? (Adjust this timeframe as appropriate)
- Are there activities or milestones you’d like to accomplish?
- Do you have any worries about your care or treatments?
- Are there things you’d like to avoid in your care?
- Would you like to involve a loved one in these decisions?
How to listen
This conversation is about your loved one’s voice and wishes.
- Listen with care and patience
- Let them share their fears, hopes and priorities
- Avoid correcting or steering the conversation; focus on understanding
After the conversation: Sharing with your care team
Writing down a few key points from your conversation can help your medical team support your loved one’s wishes.
You might include:
- What matters most to your loved one
Any specific care preferences they shared
Questions or concerns that came up
Support your family may need
Share these notes with the patient’s primary care provider. Your care team can use this information to help guide next steps.
Questions for the patient’s primary medical team
Use these questions to have a conversation with the patient’s primary care team and make sure care aligns with what matters most:
- What is my (or my loved one’s) current health status, and what can we expect moving forward?
- What are the likely benefits or risks of continuing certain treatments?
- How might care options such as palliative care or hospice help the patient and their loved ones?
- How will the decisions we make now affect future care?
- What support is available for caregivers and family members?
- How can we make sure the care plan reflects our goals and values?
- What paperwork should we complete, like an advance directive or medical power of attorney?
- How do we request a hospice referral if we feel that care is a good fit?
- What should we know about insurance coverage or costs related to different care options?
Care for every stage of a healthcare journey
As people consider their care goals, many explore options that reflect their values and changing needs. Sentara offers a full spectrum of support, seamlessly integrated into each patient’s health journey for comfort and continuity at every stage.