How to navigate family disagreements on goals of hospice care?

Ideally, every hospice patient should have a clearly laid out list of wishes about their end-of-life care which is supported by the family and meets the needs of the patient. However, things are not always ideal (and rarely are) so it’s no surprise that family members get into disagreements.

When it comes to goals of hospice care, the decision needs to be reached in a timely manner. Disagreements need to be settled by having meetings lead by a hospice social worke. During these meetings the family members along with the social worker, will go through the differences in opinions and focus on finding a solution that will benefit both, especially the hospice patient.

Who should be part of this discussion?

Every family member who is involved in the care of the hospice patient should be included in this discussion. This can be the patient’s children and can also include the brothers/sisters or close friends. It all depends on the case since every family is different.

Also, not every family is able to reach a consensus in only one meeting. If necessary, consider holding two or more meetings. On some of them you can establish the family dynamics and some might even include the hospice patient.

Have an agenda and stick to it

The goal of the meetings is to keep all family members focused on the problem. Disagreements cans steer the discussion in the wrong way. So it’s really important and helpful to have an agenda that will ensure you’re addressing the key points.

As an example, you can start each meeting with the recent updates from the doctor, and then discuss the role each family member will play in the caregiving process e.g. who will be responsible for the financial concerns, who will help out with the meals and other errands.

Share feelings

These meetings are not only about reaching caregiving decisions. Family members should also express their feelings about the loved one’s illness, how they will balance the responsibilities as well as their own work and life.

Find solutions

Even if you have excellent communication, you may not be able to get all family members to agree. They key is that you compromise and build a consensus on the best solution.

Things that you do agree on should be written down to avoid confusion. Agreed upon decisions and to-do list can be shared with all members of the family at the end of the meeting so everyone is clear on their role and responsibilities.

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