Begin Where You Are

Begin Where You Are

Start with your values. Continue with conversation. Prepare with care.

Open, honest — and yes, sometimes challenging — conversations about serious illness and dying are the foundation of our work.

Many of us know from personal experience how difficult these conversations can be, and how important they are. Often their value becomes clearer in retrospect. That is why we encourage people across New Hampshire to begin these conversations before a crisis makes them harder.

Advanced care planning for the time when we cannot speak for ourselves is grounded in developing and sharing clarity about what matters to us. What do we value most? What kinds of treatment would we accept — or decline? What trade-offs feel acceptable, and which do not? What gives our lives meaning?

Modern medical technology can now prolong life in ways that were unimaginable only a few decades ago. These advances raise an important question:

If medicine can keep us alive, does it always mean we would want it to?

The overview below begins with clarifying your own values and moves toward the conversations and planning that follow from them. Within each section are links to much more information throughout this site. If you know of resources that have helped you, we welcome you to share them with us.

Doing this work is both personal and collective. It helps us prepare for the realities of illness and death in our own lives, while also strengthening a growing movement for more compassionate end-of-life experiences.
In Taking Action, we show how.

Start With Your Values

Many people assume that end-of-life planning begins with legal documents. In reality, it often begins with something simpler: reflecting on what matters most to you.

Medical decisions near the end of life are rarely only about specific treatments. They often involve questions about quality of life, independence, comfort, and the ability to engage in the activities and relationships that give life meaning.

Taking time to think about these things can make later decisions easier for both you and the people who care about you.

We have provided a Values worksheet.

Make it Real – Document Your Wishes

First Steps:

Next Steps:

  • Talk openly with your family about what matters most to you.

👉 Download NH Advanced Care Planning Guide.pdf

👉 Download The Conversation Project’s Your Conversation Starter Guide.pdf

These steps may reduce uncertainty and help ensure that wishes are understood long before any crisis or emergency.

Conversations with Your Healthcare Proxy

Your healthcare proxy speaks for you when you cannot. If you have chosen someone to be your healthcare proxy on your Advance Directive/Living Will, the most important step is to talk with them. Set aside a quiet time to discuss your wishes, concerns, and values.

 The clearer your proxy understands your wishes, the more confidently they can speak for you if needed.

Continue to Advance Directives

Continue to HealthCare Proxy Support

Conversations with Family and Friends

We hope that those closest to us understand our values and preferences. Yet during medical crises, loved ones sometimes fall back on their own hopes and fears.

Talking openly with family and friends about your wishes can help them understand your preferences and choices so they may support you when you need it most. These conversations also support your healthcare proxy, helping them carry out your decisions with clarity and confidence.

Continue to Having the Conversation: Why it Matters

Conversations with Your Healthcare Providers

Many patients wait for their physician to bring up end-of-life planning. At the same time, many physicians are waiting for patients to start the conversation.

Don’t be afraid to talk about illness prognoses, treatment options and tradeoffs, and quality of life you want and concerns you have.  These discussions may unfold over multiple visits and over several years. Each conversation helps build the understanding needed to align your care with what matters most to you. And like conversations with those closest to you, they evolve over time as conditions change in your life.

Continue to Talking to Your Physician and Healthcare Providers

Conversations with Assisted Living and Nursing Facilities

If you are considering a continuing care retirement community, assisted living, or nursing home care, it’s important to understand how a facility approaches end-of-life care.

What matters most for many families is whether a facility is willing to honor your wishes about end-of-life care.

Continue to End-of-Life Care: Questions to Ask When Choosing a Facility