Tough Questions to Ask About a Serious Illness

There is probably no more important time to be sure you and your physician can communicate than when you have to talk about a serious illness. If you try to discuss difficult questions and you don't seem to establish good rapport, it may be time to look for a different provider. In recent years, a new medical specialty has emerged. Its called palliative care. Not only are there physicians trained to handle patients and families who are facing long term illness, but homecare organizations also have specialty services designed for providing palliative care. Sometimes the homecare services are provided by Medicare Certified Home Health Agencies and sometimes by a separate division within a hospice agency. Palliative care patients are not considered terminal the same way as in hospice. Instead, the providers are specialists in dealing with both social and medical issues that affect patients and families over time. The goal of palliative care is to help patients and families make the most out of living.

If you or someone you care about is diagnosed with a serious illness, here are some tough questions to ask:

How will this illness and its treatments likely affect my family and me?

What might the "story" of the rest of my life be like?

What kinds of complications or special needs might arise?

What is the likely time frame over which this illness will extend? How am I likely to die?

What are the best outcomes that I can reasonably hope for?

What are the worst outcomes that my family and I might have to face?

[When something new arises] Does this change what I can expect?

What symptoms am I likely to have as my disease progresses?

What medications or other treatments should I have at home in case of problems? How do I use them?

What are the shortest and longest amounts of time that I can reasonably expect? [Instead of] How long do I have?


If you or someone you love is very ill, Last Acts, a national coalition to improve care and caring near the end of life, and Handbook for Mortals: Guidance for People Facing Serious Illness by Joanne Lynn, MD and Joan Harrold, MD is a good reference. The above questions came from them with some comments of my own.