Welcome Wisdom

Constructive Conversations: From Curative to Comfort Focused Care

by Felicia Juntunen, MA, CMC, Director of Care Management

In previous newsletters, we’ve explored how families can transform challenging discussions into constructive conversations. One of the most sensitive topics in aging families is end-of-life care- a subject many find difficult to approach. As Aging Life Care professionals, we believe that informed families are better equipped to navigate these moments with compassion and clarity.

Understanding what matters most to the older adult, recognizing the signs of frailty, and knowing what resources are available all contribute to meaningful conversations and supportive decision-making.

 

From Curative to Comfort Care: Asking the Right Questions

Changes in medical technology and cultural attitudes have reshaped how families think about health care and end-of-life decisions. It’s essential to ask questions that help clarify the older adult’s values and goals:

• Will medical procedures prolong life at the expense of quality?

• Is the goal to live longer- or to live better?

Early conversations about personal preferences help guide families later, especially if they’re called upon to make decisions on behalf of their loved one. Care managers emphasize the importance of documenting preferences through advance directives, designating a decision-maker, and ensuring that person understands the older adult’s wishes.

 

Recognizing Frailty: A Signal to Reassess Care

Families often wonder when it’s time to shift the approach to care. Frailty is a key indicator. Aging Life Care professionals frequently work with individuals in their 80s and 90s, helping families assess whether medical interventions will truly benefit their loved one.

Signs of increasing frailty include:

• Sleeping more than being awake

• Difficulty rising from a chair

• Moderate to advanced dementia

• Trouble swallowing and significant weight loss

When frailty is present, the likelihood of recovery from surgery or invasive procedures diminishes. In these cases, care managers often encourage families to speak with medical providers about adjusting goals and being selective with the care they pursue.

 

Understanding Support Options: Palliative and Hospice Care

Early awareness of supportive care options helps families prepare for transitions when the focus shifts from prolonging life to preserving comfort and dignity.

Palliative care provides relief from symptoms and stress at any stage of a serious illness. It can be delivered alongside curative treatments and is often provided through clinic visits, virtual care, or occasional home visits.

Hospice care is designed for individuals with a life expectancy of six months or less. It focuses on comfort rather than cure and is delivered by an interdisciplinary team that addresses physical, emotional, and spiritual needs. Hospice care is available 24/7 and can be provided wherever the patient resides.

 

Building a Foundation for Constructive Conversations

Families can foster more compassionate and informed end-of-life discussions by:

• Understanding the older adult’s preferences

• Recognizing the impact of frailty

• Becoming familiar with palliative and hospice care resources

These strategies help families make decisions that honor their loved one’s values and promote dignity in care.