How to Start the Conversation About Your End-of-Life Wishes
Talking about death isn't easy. But talking about what matters to you before you reach the end of life is one of the most loving things you can do for yourself, and for those who care about you.
This post is here to help you start that conversation—gently, clearly, and with confidence. Whether you're planning ahead for yourself or supporting someone you love, there is wisdom in beginning this dialogue long before it’s urgently needed.
💬 What Do We Mean by “End-of-Life Wishes”?
When we talk about end-of-life wishes, we’re talking about what you want—and don’t want—if you are seriously ill, injured, or nearing the end of your life. These wishes may include:
The kind of medical care you want (or want to avoid)
Who can speak for you if you’re unable to speak for yourself
Spiritual or emotional care preferences
Whether you want life-sustaining treatments, like ventilators or feeding tubes
How you want to be supported in your final days
Organ donation and body disposition (burial, cremation, green options, etc.)
These aren’t just medical choices, they’re deeply personal values. And putting them in writing helps ensure that your voice is heard when it matters most.
🧾 Advance Directives, Living Wills, and DNRs: What’s the Difference?
There’s a lot of terminology out there, and it can be confusing. Here’s a quick breakdown:
Advance Directive
An umbrella term for legal documents that outline your health care choices in advance. This may include:
A Living Will (what treatments you do/don’t want)
A Health Care Power of Attorney or Medical Proxy (who can make decisions for you if you're unable)
Each U.S. state has its own version of these forms, but they all serve the same general purpose.
Living Will
A type of advance directive that specifies your preferences for life-sustaining treatment if you are terminally ill, permanently unconscious, or otherwise unable to express your wishes.
DNR (Do Not Resuscitate) Order
A medical order, signed by a physician, stating that you do not want CPR or other resuscitation if your heart stops or you stop breathing. This is separate from an advance directive and typically needs to be made with your doctor.
📄 Common Advance Directive Tools and Forms
Several well-respected resources can help you document your wishes in a way that’s legally valid and personally meaningful.
A widely accepted, user-friendly advance directive created by Aging with Dignity. It includes:
Who you want to make decisions for you
What kind of comfort care you want
How you want to be treated
What you want loved ones to know
Legally valid in most U.S. states and used widely in care settings.
Created for those who want to express their wishes specifically in case of cognitive decline. It outlines how you want to be supported at different stages of dementia or Alzheimer’s.
📍 State-Specific Advance Directives
Most state governments (and many hospital systems) offer free, downloadable advance directive forms. A good starting point is CaringInfo.org, which provides free advance directions and instructions for each state in a PDF format.
🌍 Moving Abroad? Check Your Documents!
If you completed an advance directive or living will in the U.S. but plan to retire or relocate to another country, be sure to check whether your documents will be recognized.
Legal requirements vary, and many countries will not accept foreign advance directives. You may need to create a new version locally to ensure your wishes are legally protected. A local attorney or healthcare advocate can help you navigate this.
🗣️ Starting the Conversation
Bringing up end-of-life wishes with family or loved ones can feel daunting, but it doesn’t have to be. These conversations aren’t about doom and gloom. They’re about making room for clarity, love, and peace of mind.
Here are some thoughtful ways to ease into the conversation:
🌱 Start with Yourself
If you’re hoping to talk to others about their plans, it often helps to begin with your own. You might say:
“I recently filled out an advance directive and it got me thinking about how helpful it is to have this figured out ahead of time.”
“I read a blog post about end-of-life wishes that made me realize I haven’t shared mine. Would you be open to talking about it with me?”
By sharing your process, you give others permission to reflect without putting them on the spot.
🕰️ Choose the Right Time
Avoid starting the conversation in the middle of a crisis or during an emotionally charged moment. Instead, look for moments of calm, trust, and connection. Good times might include:
After a medical appointment
When discussing long-term plans or retirement
During a quiet evening at home or on a walk
Around holidays, birthdays, or other milestones that naturally bring reflection
You can also set the stage in advance: “I’d love to talk sometime about our plans for the future, just to make sure we’re all on the same page. Would now be okay, or should we pick a time soon?”
👥 Talk to the Right People
You don’t need to talk to everyone all at once. Focus first on those who are most likely to be involved in your care or who may need to make decisions on your behalf. This could include:
Your spouse or partner
Adult children or close family members
A trusted friend
Your health care proxy or medical power of attorney
Your doctor or spiritual support person
You might also consider inviting a third party like a death doula, social worker, or chaplain if you think it would help ease tension, provide structure, or help you face fears or other challenges.
📚 Bring a Resource with You
Having a printed copy of something like Five Wishes or your state’s advance directive can offer a helpful anchor. You can walk through it together, ask questions, and begin clarifying values without needing to have all the answers upfront.
Even a short article, a documentary, or a news story about someone else’s experience can serve as a springboard: “I saw this video about someone whose family had no idea what they wanted when they were in the hospital. I really don’t want that for us.”
⏳ Why It Matters to Have This in Place
When we leave our wishes unspoken, we risk placing difficult decisions on the shoulders of people we love, at a time when they may already be scared or grieving.
Advance directives don’t just protect your rights. They give your family and care team clarity and peace of mind, so they’re not left guessing during moments of crisis.
💛 You Don’t Have to Do It Alone
At Life and Death Services, I offer gentle support for those exploring end-of-life planning. Whether you need help understanding your options, choosing the right documents, or talking through the emotional side of these decisions, I’m here.
This is about love. It’s about dignity. And it’s about making sure your voice is honored now and always.
And if you have a companion animal who is near their end of life, you can use an advance directive to help decide what their transition will look like as well.
