FAQs, page 3

Who needs to be included in the end-of-life conversation?
Everyone involved with the patient should be included: the patient, the family, and the medical team.

What if the medical caregivers do not acknowledge the end of life, and continue their treatments to keep the patient alive?
It is very important for the patient, if possible, and/or the family decision maker to be empowered to prevent unnecessary procedures and treatments. If there is no DNR order in place, the family needs to inform the medical team when they do not want further treatment other than comfort care. A written order should be obtained.

What if the patient and family do not acknowledge the end of life, and want the patient kept alive under all circumstances?
It is important to know what the patient and family understand about the patient's condition and prognosis, and whether all parties understand that the patient is beyond curative care. They must understand the physical and emotional impact that further treatment will have on the patient. Only then can one know what needs to be discussed. If a patient and family can be helped to understand that continued treatment will not only be futile, but also painful and uncomfortable with little benefit to the patient, they can then make a more appropriate decision. Ironically, research has shown that in the absence of futile care, patients sometimes live longer and families recover from their loss more easily.

What if the patient is incapacitated and unable to participate in the conversation?
The end-of-life conversation still needs to take place with the family and/or the patient's surrogate decision maker. The conversation should still "include" the patient, and take place at the patient's bedside.

How is The Wisdom of Ruth project involved in these end-of-life conversations?
We strive to raise the consciousness level of the medical team, the patient and the family regarding the importance of the end-of-life conversation. We do this through training workshops for all members of the medical team, as well as presentations, classes, and consultations.