My last conversation with Grandpa was over the phone. He was sick and dying. I was 1,200 miles away in residency, learning how to be a family physician. I was not going to make it home in time to see him one last time. 

We did not know exactly what was wrong. Sure, he could have had more tests and been admitted into the hospital, but that was not what he wanted. Thankfully, a family friend and physician had talked to my grandparents about their end-of-life goals. This discussion helped Grandpa realize what was important to him, like his faith and being with Grandma, and what was not, like spending time in doctor’s offices and hospitals. 

Even though I was a physician in training, I supported his choice. He was in a peaceful place, listening to music, talking with Grandma and other friends and family. 

Most people want to die at home. However, only 20 percent do. When it comes to dying, some advance planning may make a world of difference. 

It does not require an official document or appointment with a lawyer to make plans for how you would like to spend your final days. It does not even necessitate a visit with your doctor, although all the above may help. The most important thing is talking to your loved ones about your wishes and goals of care.  

How do you know when to have this talk, how to bring up the topic, and what to say during the conversation? How and when do you say “enough is enough” when it comes to searching for a cure, a surgery, a treatment, or spending a few more nights in the hospital? Discussing these questions may not be easy, but it is more productive and less stressful to have the conversation now rather than during a crisis.

Start with scheduling an appointment with your doctor for the sole purpose of talking about your end-of-life goals, expectations, and values. Then, together, adjust your care plan accordingly. Revisit these discussions periodically with your family and your healthcare providers. 

It was tough not being there with Grandpa, but he was at peace, so I was at peace. This past year, many others have had to say goodbye remotely or did not even have the chance. This is a reminder for us all to have meaningful conversations, to tell our loved ones how much they mean to us, and to cherish the time we do have together. 

Richard P. Holm, MD, passed away in March 2020 after a battle with pancreatic cancer. He is founder of The Prairie Doc. For free and easy access to the entire Prairie Doc library, visit www.prairiedoc.org and follow Prairie Doc on Facebook. Andrew Ellsworth, M.D., is part of The Prairie Doc® team of physicians and currently practices family medicine in Brookings, S.D.