Conversations about end-of-life care can be difficult. They often bring up strong emotions, differing perspectives, and complex decisions. But they’re absolutely necessary.
“It’s my mother and I don’t want to talk about her dying. That subject makes me uncomfortable. But I know it is a conversation that is needed, so I have to become comfortable.”
– Decade of Choice survey respondent
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Who will you include in your end-of-life conversations?
People often turn to those closest to them for support. Your circle can include close friends, chosen family, or others who are important in your life, whether or not you are biologically or legally related.
Common topics to discuss
End-of-life conversations may include:
End-of-life wishes
Your preferences for care, treatment, and decision-making.
Health care and emotional support
Who will provide care, where it will take place, how it will be coordinated, and any related financial considerations.
Arrangements for end-of-life ceremonies
Your wishes for a funeral, memorial, or celebration of life, including any relevant financial planning.
Medical assistance in dying
If medical assistance in dying is part of your plan, sharing key details well in advance can help others understand your decision.
This is emotional territory. People may need time to process and revisit the conversation. Be gentle but clear.
Consider a structured meeting
Bringing people together can create shared understanding. If you’re planning a family meeting, some preparation can help.
Think about who to include
Deciding who to invite can be sensitive. Being transparent about who you’d like to include can reduce tension.
Set expectations in advance
Let people know what you’d like to discuss, who will be there, and whether the goal is to share information, hear perspectives, or make decisions together.
Choose a supportive setting
In person or virtual, what matters is that people feel comfortable and focused.
Keep it simple
A loose plan can help guide the conversation while leaving space for questions and emotional responses.
Allow for follow-up
Not everything will be resolved in one conversation. Ongoing check-ins create clarity and connection.
Common challenges
Family members may have different expectations, communication styles, and levels of comfort. Common challenges include:
Emotional reactions and barriers
Fear, denial, or grief can make conversations difficult, leading people to avoid or struggle to express themselves.
Attitudes towards death and dying
Cultural, spiritual, or personal beliefs shape what people are comfortable talking about and how they respond.
Differences in understanding
Varying levels of knowledge about aging, death, and dying can be shaped by incomplete, outdated or misleading information, and affect how people engage.
Practical pressures
Time constraints, geographical distance, caregiving demands, or medically urgent situations can limit space and time for thoughtful discussion.
Family dynamics
Existing patterns, such as conflict, avoidance, or estrangement, and familiar roles, such as caregiving, decision-making, organizing, or offering emotional support, can emerge.
Recognizing these common challenges does not remove them, but it can help to know your family is not alone in finding this conversation difficult. Noticing these dynamics helps you understand people’s reactions and can guide you in deciding when to step in, when to step back, and how to support the conversation.
“It is simply an uncomfortable topic to talk about, but I feel it's an important one to have, so we sit down and discuss the future. Sometimes it's little conversations, but it still works.”
– Decade of Choice survey respondent
Focus on the person who is dying
Some families find that the focus can shift toward logistics, finances, and the loss that others will experience. If you’re leading or organizing these discussions, returning attention to the person who is dying can keep the conversation grounded in what matters to them.
This may mean creating space for them to speak openly and listening without judgment. Not every conversation will lead to resolution – presence and patience can matter as much as agreement.
Tips for involving children and teens
Children are often aware that something is changing, even if it’s not openly discussed. Including them in age-appropriate ways can reduce confusion and anxiety.
Be aware of developmental levels
When discussing death with children, adults can tailor their language and level of detail to what each child can understand. Children under five may not fully understand the concept of death but still feel a sense of loss. Older children and teens can grasp the permanence of death and may have more complex responses.
Use honest communication
Clear, direct language is helpful. Avoid vague or indirect language when talking about death. Encourage children to ask questions and offer validation for their feelings.
Allow space for expression
Children may process emotions through play or creative activities. They may also express themselves in unexpected moments with adults they trust.
Resources for children and youth
Canadian Virtual Hospice offers two dedicated resources for young people navigating grief and loss. kidsgrief.ca includes a MAID-specific activity book for children, and youthgrief.ca offers support tailored to teens and young adults.
There’s no single right way to involve children and teens, but an attitude of openness – and being available to answer their questions – can help them feel supported.
General communication tips
How you talk about death matters.
Talk about it early and often
Try to talk about death in small and frequent conversations well in advance of crisis situations.
Find ways to raise the topic
Use indirect ways to raise the topic conversationally, such as mentioning news stories or personal anecdotes.
Be direct and patient
When discussing your wishes, aim for openness and clarity, while allowing space for different reactions. People may need time to process before they’re ready to respond.
Choose who you talk to
Be intentional about who is included in the conversation about your end-of-life wishes. This can help you feel supported and prevent conflict and confusion.
Learn from others
These conversations may not resolve everything, but they can create a foundation for ongoing dialogue. Discover how other families have talked about death and dying in the Video Gallery.
