If your family has already discussed your loved one’s end-of-life care preferences, you’ve taken a meaningful and often difficult first step. But having that conversation isn’t enough on its own. To ensure those wishes are honored when the time comes, it’s equally important to involve your loved one’s healthcare providers—especially their primary care physician.
Even healthy older adults can face sudden medical changes. That's why these conversations should happen during times of relative stability, not in the middle of a crisis when decisions may be rushed or emotionally overwhelming.
Healthcare providers play a pivotal role in honoring advance directives. Yet, many physicians won’t initiate end-of-life care discussions unless prompted by the patient or family. Fortunately, Medicare recognizes the importance of these conversations and reimburses doctors for the time spent having them. That means your family can—and should—schedule a dedicated appointment for this purpose.
To make the most of this important conversation, preparation is key. Here’s how to guide the process:
Don’t just bring it up at a routine check-up. Call the doctor’s office and ask to set up an appointment specifically to talk about
advance care planning. This gives the physician time to review your loved one’s health history and come prepared for a meaningful discussion.
Help your loved one reflect ahead of time. Do they want every possible life-extending treatment (“do everything”), or do they prefer comfort-focused care (“no heroics”)? Are there specific procedures or scenarios they would like to avoid? Religious beliefs, cultural traditions, and past experiences with illness or death in the family may shape these preferences.
If your loved one has completed an advance directive or living will, bring a copy and ensure it becomes part of their official medical record. This ensures the care team knows their documented wishes and can act accordingly in an emergency.
Your loved one’s doctor may ask about their wishes regarding:
While it can be life-saving, CPR often causes broken ribs or significant trauma in older adults—and may not lead to meaningful recovery.
This may prolong life in some cases, but not all. Ask about potential complications and when it might be beneficial or not.
Life support via ventilator can sometimes help patients recover. However, long-term use may lead to infections, discomfort, and extended ICU stays with uncertain outcomes.
Encourage your loved one to ask questions about each option: What are the benefits? What are the risks? What is the likely quality of life afterward?
These are not decisions anyone should make alone—or under pressure.
How Geriatric Care Managers Can Help
Navigating end-of-life care planning is emotionally and logistically complex. A geriatric care manager (GCM) acts as a compassionate guide for families, helping initiate these delicate conversations, interpret medical information, and ensure advance directives are communicated across your loved one’s care team.
GCMs can:
With the support of a care manager, your family gains peace of mind knowing your loved one’s voice will be heard—even if they can no longer speak for themselves.
Start the Conversation Before It’s Too Late
Planning ahead ensures your loved one’s wishes are honored and can spare your family unnecessary stress during critical moments.
