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How to Talk to Your Family About Your Health Care Preferences

 Everybody dies. Yet, it can be hard to talk about our deaths until absolutely necessary.

That can mean leaving loved ones with difficult decisions while they’re also facing the idea of losing you.

They may be left struggling to answer questions on your behalf such as:

  • What would you want them to tell a doctor if the only thing keeping you alive is a breathing machine and a feeding tube?
  • Would you want them to agree to surgery for an unrelated medical problem if you were in a coma with little chance of waking?  
  • If you were experiencing the last stages of a terminal illness, would you want the hospital to do everything possible to keep you alive until the end?

90% of people say talking with their loved ones about end-of-life care is important. Only 27% have actually done it.

“Unfortunately, people only start thinking about these things and having discussions with their loved ones or their doctor during a crisis,” says Tennessee Department of Health patient care advocate Sally Pitt. “We plan everything around weddings, the birth of a child, graduation from high school and college, but we don’t plan on how we want to spend our last months or days.”

Getting started

Honoring Choices Tennessee, a statewide effort by the department of health, other state agencies, private industry, health care associations and other organizations throughout Tennessee urges all adults to seriously think about the answers to such questions early, and to create an Advance Directive for Health Care (formerly known as a Living Will), laying out your decisions about end-of-life care. That way, if you are unable to communicate your wishes due to a dire medical condition, your family and doctor will have clear instructions to follow.

An advance directive is a written statement of a person’s wishes regarding medical treatment, made to ensure those wishes are carried out should the person be unable to communicate them to a doctor

The coalition also suggests appointing somebody you trust as your health care agent, to make health care decisions for you if you can’t.

Tennessee offers a simple two-page document that contains both forms. Though it is a binding legal document, you don’t need a lawyer to complete it. Once completed, all that’s required is the signatures of two witnesses.

Clear communication

Many people feel they’ve made their wishes about care at the end of life clear to their family or doctor because they’ve made a general statement about not wanting to be hooked up to machines at the end. But that might not apply to your situation when an actual medical situation arises, and without clear direction, your doctor and family will need to figure out what you might want.

In fact, you may not have considered all of your options. Filling out an Advance Directive for Health Care form requires you to think about exactly what you want, and what you consider to be an acceptable quality of life in your final days.

There are 4 steps to create your advance directive:

  1. Download the Tennessee Advance Directive form (also available in Spanish).
  2. Talk to your family.
    This can be difficult. Spouses or children may shy away from the discussion because they don’t want to think about such circumstances. The Conversation Project offers guidance that helps you form your thoughts and present them to loved ones.
  3. Complete the form.
    Have it signed by two witnesses or a notary public.
  4. Keep a copy in a safe, easily accessible place.
    Give copies to family members and/or close friends. Give a copy to your doctor.

It’s a good idea to review your advance directive when life circumstances change through a divorce, the death of a loved one, or diagnosis of a serious illness. You may change your mind about who you want as your health care agent, or what kind of care you would like. If you do want to make changes, your best option is to complete a new form and destroy all copies of the old one.

Peace of mind

Though you will hopefully be around for years to come, you want to be prepared for the unexpected. Just as you draw up a will or purchase life insurance, completing an advance directive is a way to protect your loved ones. While a car accident or illness can happen at any age, knowing you’ve made sure your loved ones know your wishes can bring you peace.

Nancy Henderson

Nancy Henderson, a writer and editor originally from New York, moved to Nashville more than 25 years ago and considers herself more Tennessean than Yankee these days. She has written about health care and wellness for a variety of publications.

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Get more information about specific health terms, topics and conditions to better manage your health on BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.

Filed under: Mind & Body


Nancy Henderson, a writer and editor originally from New York, moved to Nashville more than 25 years ago and considers herself more Tennessean than Yankee these days. She has written about health care and wellness for a variety of publications.


WellTuned provides inspiration and practical advice for healthy living.
WellTuned does not offer medical advice. Any personal health questions should be addressed to your doctor.

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