Making Decisions for Someone at the End of Life: A Compassionate Guide

by Active Bot

It’s never easy to navigate the delicate path of making decisions for someone reaching the end of their life journey.

If you find yourself in this position, you’re likely grappling with questions on how to ensure comfort, prevent suffering, and enhance the quality of the remaining time for your loved one. The responsibility of making decisions, especially in the absence of prior discussions or conflicting family opinions, can be overwhelming. We’re here to guide you through this challenging process, offering insights, strategies, and personal stories to help you find clarity amidst the complexity.

Addressing Advance Care Wishes: A Vital Step

In the throes of end-of-life decisions, having access to a person’s advance care plan is crucial. If written documents exist, such as a do not resuscitate order, informing the attending doctor promptly is essential. For those receiving end-of-life care at home, securing an out-of-hospital order is necessary to ensure that emergency medical technicians respect the person’s wishes. Hospice staff can play a pivotal role in determining whether a medical condition is part of the natural dying process or requires immediate attention.

Decision-Making Strategies: Substituted Judgment and Best Interests

When faced with decisions not addressed in advance care plans, two approaches come to the fore: Substituted Judgment and Best Interests. Substituted judgment involves putting yourself in the dying person’s place, deciding as they would. On the other hand, the Best Interests approach requires you to determine what you believe is best for the person based on your representation of their wishes.

Joseph and Leilani’s Story

Joseph faced a heart-wrenching decision when his 90-year-old mother, Leilani, slipped into a coma after a major stroke. Drawing from his mother’s disapproval of a similar situation with a neighbor, Joseph declined the option of putting her on a ventilator. Leilani passed away peacefully, illustrating the power of the substituted judgment approach.

Ali and Wadi’s Story

Ali, dealing with his 80-year-old father Wadi’s advanced lung cancer and Parkinson’s disease, had to make a decision about surgery. Despite medical suggestions, Ali chose the Best Interests approach, deciding that subjecting his father to surgery and potential pain would not enhance Wadi’s quality of life.

Questions to Ask When Making Decisions

When making decisions for someone at the end of life, consider the following questions:

  • Have they ever discussed their end-of-life wishes?
  • What values gave meaning to their life?
  • Are they still able to participate in activities they loved?
  • What might happen in the next few hours, days, or weeks with the current treatment?
  • Will treatment provide more quality time with family and friends?
  • When should hospice care begin, and where can it be administered?
  • What medicines will be given, and what are the possible side effects?

Remember, the more information you have, the better equipped you’ll be to make decisions aligned with the person’s wishes.

Cultural Considerations: Acknowledging Diversity at the End of Life

Understanding how a person’s cultural background influences expectations and choices is paramount. Different cultural and ethnic groups may have varying expectations regarding care. It’s crucial to communicate your family’s traditions, religious beliefs, and cultural practices with the healthcare team to ensure personalized, respectful care.

Discussing a Care Plan: Importance and Key Questions

Having a comprehensive care plan in place is crucial for honoring a person’s wishes at the end of life. A care plan includes health conditions, medications, emergency contacts, and end-of-life care preferences. Family involvement in the care plan is common, and if disagreements arise, mediators or palliative care clinicians can help navigate these discussions.

Key Questions for the Medical Staff

  • What is the best place for the type of care the person wants?
  • What decisions should be included in the care plan, and what are the benefits and risks?
  • How often should the care plan be reassessed?
  • What is the best way for the family to work with the care staff?

Staying Connected: Communication with the Healthcare Team

Maintaining open communication with the healthcare team is crucial. Questions about the care plan, updates on the person’s condition, and financial aspects should be discussed regularly. It’s advisable to have one designated family member as the main point of contact to streamline communication.

Seeking Information Beyond End-of-Life Decisions

As you navigate this challenging time, consider exploring:

  • Different care settings at the end of life
  • Advanced care planning
  • Palliative care and hospice care

Remember, each family’s journey is unique, and seeking information can empower you to make informed decisions.

For more information about end-of-life care for people with dementia

NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center
[email protected]
The NIA ADEAR Center offers information and free print publications about Alzheimer’s and related dementias for families, caregivers, and health professionals. ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.
Explore the website for information and resources on Alzheimer’s and related dementias from across the federal government.

Eldercare Locator
[email protected]

National Institute of Nursing Research
[email protected]

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.


  1. How can I handle disagreements within my family about end-of-life decisions?
    • Open communication and, if needed, involving a mediator can help reach a consensus.
  2. What role does cultural background play in end-of-life care?
    • Cultural background influences comfort care, pain management, decision-makers, and preferred locations for end-of-life care.
  3. Why is a comprehensive care plan important at the end of life?
    • A care plan ensures that a person’s health conditions, preferences, and post-mortem wishes are respected and followed.
  4. How can I ensure effective communication with the healthcare team?
    • Designate one family member as the main point of contact and maintain regular communication about care plans and updates.
  5. What resources can I explore beyond end-of-life decisions?
    • Look into different care settings, advanced care planning, and information about palliative care and hospice care.

Focus Keywords: End-of-life decisions, Care plan, Cultural considerations, Communication, Palliative care, Hospice care.

SEO Title: Navigating End-of-Life Decisions: A Guide to Compassionate Care

Slug: end-of-life-decisions-guide

Meta Description: Explore compassionate strategies for making end-of-life decisions, addressing cultural considerations, and creating a comprehensive care plan. Navigate this sensitive journey with informed insights.

Alt text image: A caring hand supporting a fragile leaf, symbolizing the delicate nature of end-of-life decisions.

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