Kahlil Gibran once said, “For life and death are one, even as the river and the sea are one.” Angelo Volandes, a physician, writer and patients’ rights advocate, has a lot in common with Gibran’s thought on life and death being one. In his book, The Conversation: A Revolutionary Plan for End-of-Life Care, Dr. Volandes speaks to the importance of improving not how we die, but more importantly, how we live through the end of our life.

His book shares how people can empower themselves to get the right medical care on their terms at the end of life. Good quality care requires that treatments are consistent with the patients’ values, preferences and priorities, and communication is vital in knowing those. Caregivers and doctors can make a world of difference in hard situations by having these conversations.

In The Conversation, Dr. Volandes offers a “how-to” guide for having tough discussions when facing serious illness. He recommends talking about these four questions.

1. 1. What is important to you, and what makes you happy?
   2. What fears do you have about sickness and medical care?
   3. Are there any treatments that you believe would be too much for you?
   4. Do you have any beliefs that guide your ideas about medical care?

According to Dr. Volandes, these are just the start of what should be an ongoing conversation with doctors and loved ones about your wishes. He also suggests discussing:

• • Would you rather live longer no matter what, or is quality of life more important to you?
  • Are there any significant events you have to see before you die (e.g., graduations, weddings or birthdays)?
  • How much pain you are willing to go through, and are you willing to tolerate some pain if it means you can still interact with other people?
  • Do you want to be at home or in a hospital when you die?

Rather than waiting for these conversations to come up organically, Dr. Volandes suggests his readers initiate them. His goal is to build strong patient/clinician relationships based on shared knowledge and open communication, creating high-quality medical care that is person-centered, respecting patients’ preferences.

“When patients have honest exchanges and have the tools necessary to understand their choices at the end of life, then they—not the health care system—remain in charge of decisions about how they want to live.” – Dr. Volandes, The Conversation

How a person wants to live is just as important as how a person wants to die. Providing people with compassionate and person-centered care in life and death is care everyone should receive. Begin “the conversation” today to ensure respect and choice.

For additional information on how to live well through the end of your life, check out The Gift of Five Wishes.