Q. My daughter is a hospice nurse, and she often finds herself in the middle between family members who can’t agree on care decisions for her patients who are dying. Shouldn’t families in that position already have a plan?

A. In a perfect world, we would all feel comfortable sharing our wishes about death and dying with our loved ones. But the reality is many families haven’t had these important conversations. Recent surveys show that only about half of Americans are familiar with advance care planning. That’s why hospice nurses like your daughter often find themselves helping families navigate these difficult decisions in real time.

It can be hard to know where to start but making decisions and putting a plan in place can reduce stress on families and ensure healthcare wishes are honored. April 16th was National Healthcare Decisions Day, which is observed each year to remind us about the importance of advance care planning. The Conversation Project has resources to help people share their wishes for care through the end of life, including a Conversation Starter Guide, which offers practical steps to get you thinking and talking.

Think about what matters to you. Before diving into a conversation, take some time to think about what a good day looks like to you. What would be most important to you as you think about the end of life? Is it being able to recognize your children? Being independent?

Plan your talk. The Conversation Project has a list of questions to consider. Write down your answers to questions like, “When it comes to medical decisions, do I want to be in charge, leave it in the hands of my team, or somewhere in between?”

Start talking. Think about where and when you will share this information and who you would like to share it with. It can even be a good idea to rehearse what you want to say in your head beforehand. You don’t have to cover everything in the first conversation. Try to listen and build trust.

Keep talking. Share your wishes with people you trust. The more you talk, the more friends and family will know what matters to you, which will make it more likely that you’ll get the kind of healthcare you want.

You can find The Conversation Project starter guide and other resources on their website: www.theconversationproject.org/. Once you’ve had the conversations, put your wishes in writing in what’s called an advance directive. Advance directives typically include two parts. Your health care proxy, which is the person you name to carry out health care decisions on your behalf, and your living will, which describes your health care preferences if you can’t speak for yourself. Make copies of these documents for anyone who might need them.

Your daughter’s experience is a good reminder about the importance of talking about death and dying before it’s a crisis. The earlier we start, the more prepared we’ll be for our final days and those of the people closest to us.

Are you caring for an older adult or need help finding healthy aging resources? Our experienced staff is available to help. Visit us online at www.agespan.org. You can also call 800-892-0890 or email info@agespan.org. 

Joan Hatem-Roy is the chief executive officer of AgeSpan, which serves the following cities and towns: Amesbury, Andover, Billerica, Boxford, Chelmsford, Danvers, Dracut, Dunstable, Georgetown, Groveland, Haverhill, Lawrence, Lowell, Marblehead, Merrimac, Methuen, Middleton, Newbury, Newburyport, North Andover, Peabody, Rowley, Salisbury, Salem, Tewksbury, Tyngsboro, Westford, and West Newbury.