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Discussing End-of-Life Wishes

Dear Barbara, I recently found out I am to be the Power of Attorney for my parents (who are in their 80s). I am interested in resource material that can guide me in how to discuss end of life wishes with them. They are healthy.


First, there are two kinds of Power of Attorney. One addresses financial and estate issues, a Power of Attorney. The other is a Durable Medical Power of Attorney. It addresses ONLY medical issues. You want both so that when your parents can’t speak for themselves medically you can speak and act for them in that regard also.

It isn’t enough to just have the medical power of attorney for them, you have to find out what your parents’ wishes are. What are their thoughts on end of life issues, on use of narcotics, on artificial feeding, on DNR (Do Not  Resuscitate), on CPR (cardio/pulmonary resuscitation), on being a No Code?

It is a tough conversation to have. People are often reticent to talk about dying. We have it in our heads that if we talk about dying and death that will make it happen. If we play the ostrich game we won’t tempt fate. In the back of our minds we believe that other people die, not me, and not anyone close to me. So who needs plans?

I often get the question, “How do I start an end of life discussion? How do I get my family to talk about what they want their dying to be like?” My answer? Just ask them. You may be surprised at how open the conversation will be, how much you will learn, how easy it will be.

Consider this for the reason you need to have “the conversation:” If you don’t have someone speak for you (a durable medical power of attorney) or if you as a durable medical power of attorney don’t know what the person would do if they could speak for themselves, the medical establishment will make the decision for you and for your loved one. If you don’t spell out your wishes or know your person’s wishes about end of life issues the medical profession will do EVERYTHING it can to keep the heart beating and the body breathing, under any circumstances. Even if the body can’t.

So back to how you talk with someone about end of life plans ——-Just say, “You probably don’t want to talk about this but we need to. Please hear me out.” And begin the conversation. You can Google Advance Directive forms and print them out. Also, you might want to look at Five Wishes ( As you fill out the forms, together, talk about each section. When it’s done, it’s done. Put it in a safe place and move on enjoying life.

Something more… about Discussing End-of-Life Wishes

While everyone is healthy and calm you may want to watch my film, NEW RULES for End of Life Care together.  It is a tool for having “the conversation.” It will answer so many questions about what normal, natural dying looks like and how to advocate for the kind of care that they/you want.  Another tool for this discussion is The Death Deck– a card game that asks the questions in a fun way. 

Originally Published on

Barbara Karnes Registered Nurse

Barbara Karnes, RN Award Winning End of Life Educator, Award Winning Nurse, NHPCO Hospice Innovator Award Winner 2018 & 2015 International Humanitarian Woman of the Year

While at the bedside of hundreds of people during the dying process, Hospice Pioneer Barbara Karnes noticed that each death was following a near identical script. Each person was going through the stages of death in almost the same manner and most families came to her with similar questions. These realizations led Barbara to sit down and write Gone From My Sight, "The Little Blue Book" that changed the hospice industry.

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