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Living & Aging Well: Four steps for talking with the important people in your life
This guide can help you talk with the important people in your life about what matters to you in your care.
Living and Aging Well: Talking with your clinician about what matters to you in your care
This guide can help you talk with your clinician about what matters to you in your care.
What Matters to Me Workbook
Ariadne Labs, in collaboration with The Conversation Project, developed the What Matters to Me Workbook. It is designed to help people with a serious illness get ready to talk to their health care team about what is most important to them. This link will bring you to the Ariadne Labs website where you can download the workbook in English, Chinese, or Spanish.
Get Palliative Care
Are you or a loved one living with a serious illness? Palliative Care can help. Palliative care is specialized medical care focused on relieving the symptoms and stress of a serious illness. It is appropriate at any age and at any stage, and you can have it along with curative treatment. The goal is to improve your quality of life.
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Living & Aging Well: Four steps for talking with the important people in your life
Living & Aging Well: Four steps for talking with the important people in your life
This guide can help you talk with your loved ones about the future of your health and about how you are coping now to live as well as possible. It is based on what you have already talked about with your clinician.
Talking about your health with the important people in your life may not be easy, but it will help them understand what is important to you. It will also help them support you now and in the future.
Before you talk to the important people in your life, think about when and where you want to talk. Choose a time and place when you feel relaxed. Be sure you have time to talk for a while. You can use the words in this guide or use your own words — whatever is easier for you.
Step 1: Start the conversation
- I am doing OK right now, and even though there is no rush, my clinicians think we need to begin talking about my future care.
- They believe in being prepared and want to know my goals and wishes for medical care.
- Since you are important to me, I’d also like you to be part of the conversation.
- If at some point I can’t speak for myself, I want you to be able to make decisions for me.
Step 2: Check in with your loved one
UNDERSTANDING
- What is your understanding now of where I am with my health?
INFORMATION
- I know that it may not be easy, but I would like to share information about my health with you. Is that okay?
- My clinician and I talked about the outlook for my health – can I share that with you?
Step 3: Talk about what matters most
- HOPES I hope that in the days ahead that I will continue to…
EXAMPLE: feel well for a long time, or that I can get stronger.
- WORRIES I am worried that in the days ahead I…
EXAMPLE: may get weaker, or that time may be shorter than we hope.
- WHAT’S MOST IMPORTANT I’d like to share what is most important to me if my health were to worsen…
EXAMPLE: spend time with the important people in my life, maintain independence, be comfortable, live as long as possible, fight the illness, die a natural death, not be a burden, be mentally aware, etc.
Step 4: Talk about how you are coping
- Most people with serious illness swing back and forth between times when they are more worried and times when they are more hopeful. Being worried and hopeful is a healthy, natural part of coping.
- Talking about your coping helps loved ones know how to best support you.
Everyone is different and there are lots of healthy ways to cope. You can use the list included in the downloadable PDF to help you identify approaches to live well.
Why is this important?
Thinking about and sharing your wishes will give you more control over your care. It also helps to prepare your loved ones to make decisions for you if you can’t make them at some point in the future. Talking with the important people in your life ahead of time will ease the burden on them of making hard decisions for you if you can’t speak for yourself.
You may find it helpful to bring other people to your visit.
You can choose to bring the person who is your Health Care Agent or another important person in your life to your visit so they can be a part of the conversation.
Talking about the future won’t change your ongoing care.
Talking about the future won’t change the plans we have made so far about your treatment, unless you want it to. We will continue providing the best possible care to treat your illness.
We understand that your wishes may change over time.
This is the beginning of an ongoing conversation and you can always change your mind. We know that you may have other questions or concerns in the future. We will continue to support you and answer your questions so that you can make informed decisions about your care.
Living and Aging Well: Talking with your clinician about what matters to your in your care
Living and Aging Well: Talking with your clinician about what matters to you in your care
Understanding what matters to you about your health is important to us at MGH. Over time, your clinician would like to talk with you about your goals and wishes so, together, you can plan for your care together. These discussions are an important part of the care we provide for all of our patients.
A good time to talk about your goals and wishes is often when you are feeling well and before there are any big decisions to be made about your medical care. Patients who think through what is important to them and what their wishes are often feel less anxious, more at peace, and more in control of their situation.
Here are some questions you can think about:
- What would you like to know about your illness and what may happen in the future?
- What kind of information would help you make decisions about your future?
- What does living well look like to you?
- Thinking about your medical problems, what are you worried about?
- What kinds of medical care do you want or not want?
- What do you think it would be like to share these thoughts with the important people in your life?
- If you haven’t already identified a Health Care Proxy (medical decision maker), who would you want to fulfill that role? A Health Care Proxy (medical decision maker) is someone who can make medical decisions for you if you are too sick to make your own decisions.
The following can be helpful for your team:
- If you have a Health Care Proxy (medical decision maker) form that names someone to be your agent, please bring a copy.
- If you have a Living Will or Advance Directive, please bring a copy.
If you don’t have these documents or have questions about them, talk with your clinician or find resources at prepareforyourcare.org.
Why is this important?
Thinking about and sharing your wishes will give you more control over your care. It also helps to prepare your loved ones to make decisions for you if you can’t make them yourself at some point in the future. Talking with the important people in your life ahead of time will ease the burden on them of making hard decisions for you if you can’t speak for yourself. Getting health care often involves choices that impact your life and wellbeing in different ways. Treatments only work if they work for you.
You may find it helpful to bring other people to your visit.
You can choose to bring the person who is your Health Care Proxy (medical decision maker), other family members, a close friend or other important people in your life to your visit so they can be a part of the conversation.
Talking about the future won’t change your ongoing care.
Talking about the future won’t change the plans made so far about your treatment unless you want it to. We will continue providing the best possible care to treat your illness.
We understand that your wishes may change over time.
This is the beginning of an ongoing conversation and you can always change your mind. We know that you may have other questions or concerns in the future. We will continue to support you and answer your questions so that you can make informed decisions about your care.
What Matters to Me Workbook
Get Palliative Care
Patient Events
The Continuum Project team is thrilled to offer live, interactive sessions for patients & families that discuss how to “PREPARE For Your Care.” Each session will cover the following topics:
- Choosing a Health Care Proxy (Medical Decision Maker) if you can't speak for yourself
- Thinking about your values
- Telling others about your wishes
Sessions are 90 minutes and currently offered virtually via Zoom and in-person. We offer sessions in both English and Spanish. Details for each session are outlined below. Registration is required. Check back frequently for our upcoming event offerings!
Planning
Serious illness care planning can at times feel overwhelming. There are many tools available to help better understand the process and prepare you and your family for what may lie ahead. Here are some resources we think may be helpful.
Cake is a secure app that makes it easier for people to discover their advance care planning preferences and share them with loved ones. You can create an online profile and answer simple questions about your healthcare, legal/financial, funeral and legacy wishes. In this profile, you can create documents like a Health Care Proxy and Advance Care Plan. All preferences are securely stored and saved to your profile, which can only be accessed by family or loved ones you choose. Cake is also a Continuum Project collaborator.
More Info
PREPARE for Your Care is a web-based resource that helps people learn about and prepare for medical decision making. This evidenced-based tool features video stories in English and Spanish, and guides users as they explore their wishes and learn how to discuss them with family, friends and medical providers. PREPARE also offers easy-to-read, legally-binding advance directives for all 50 states in English and Spanish. PREPARE is also a Continuum Project collaborator.
More InfoAdditional Resources:
- Advance Care Planning Decisions offers planning resources and information
- Five Wishes a legal advance directive document available in various languages
- Respecting Choices address the serious illness care planning process
Books
A Beginner’s Guide to the End
by B.J. Miller and Shoshana Berger
A practical, compassionate, and comprehensive guide to the end of life, and how to live fully until then.
Frequently Asked Questions
What is the Continuum Project?
The Continuum Project is a Massachusetts General Hospital (MGH) culture change initiative that grew out of a 2015 taskforce convened by MGH president, Dr. Peter Slavin, and charged with developing a comprehensive strategy to care for patients and families facing serious illness. Our team works to implement the Serious Illness Care Program at MGH, to engage patients and families in living well now and preparing for the future, and to develop educational material for clinicians, patients, and families.
What is the Serious Illness Care Program?
The Serious Illness Care Program is a system-based approach for improving serious illness care developed at Ariadne Labs. The program includes (1) tools for patients and clinicians, including a clinician facing serious illness conversation guide, (2) training for clinicians, and (3) systems change such as electronic medical record modification. The Serious Illness Care Program is being implemented at institutions across the U.S., including MGH.
How does the Continuum Project help patients and their families?
The Continuum Project works to improve the serious illness experience for patients, families, clinicians, and staff. Many clinicians at MGH have been trained on our curriculum and share our vision in promoting a culture of living well with a serious illness. Our work includes resources and educational sessions for patients and families.
What is palliative care?
Palliative care provides specialized, multidisciplinary medical care for people with serious illnesses. It is focused on improving quality of life for both the patient and the family—providing relief from the symptoms, pain and stresses of a serious illness—whatever the diagnosis. It can also be provided concurrently with curative treatment.
What is a serious illness conversation?
Serious illness conversations occur throughout the illness and explore the patient’s values, goals, and wishes. The goal is to support patients and families to live as well as possible with the illness and to be prepared.
Why are serious illness conversations important?
Serious illness conversations are valuable because they help patients experience less emotional suffering, reduce anxiety, and facilitate goal-setting and higher quality of life. They ensure that clinicians are aware of their patients’ wishes, and that patients have an opportunity to express and develop their future plans with their clinician.