The Caregiver Conversation Workshop

• Welcome + housekeeping (2 min) • Acknowledgment: "Some of you are in the middle of this right now. Some of you have been through it. Some of you are preparing. All of those are okay. We're going to go slow." • Three things we'll cover (3 min) • Pause. Let the room breathe. (2 min — yes, really)

The Healthcare Power of Attorney — 10 min: • Names the person who decides when the patient cannot • Must be signed while the patient is competent • State-specific (varies by state — we have the 50 versions) • Banks and hospitals have their own form preferences — sometimes • What to do if your parent never signed one and now can't The Living Will / Advance Directive — 10 min: • The patient's wishes in writing • DNR vs DNI vs full code — what each means • Hospice election (NOT the same as DNR) • Comfort measures vs life-prolonging treatment • The HIPAA authorization that makes everything else usable ACTIVITY: Handout — "Three Questions to Ask Your Parent Before the Hospital Visit." Participants take 5 minutes to read and think. No sharing, no calling on people. Just reading.

This isn't about death. It's about CARE. The conversation script (5 min): "Mom/Dad, I want to make sure I know what you want if you ever can't tell us yourself. Not because something is happening — because I want to honor what you want, not guess at it." What to cover, in order (10 min): 1. Where do you want to be cared for? (Home, my home, a facility, hospice) 2. Who do you want making decisions for you if you can't? (Name. Backup. And do they know?) 3. What does "comfortable" mean to you? (Some people want every intervention. Some want morphine and a window with a view. Both are valid.) 4. Is there anything you specifically do NOT want? (No feeding tube. No ventilator past 7 days. No CPR. No transferring to a hospital from home.) 5. Who do you want with you? The hardest one — 5 min: How do you know it's time for hospice? Most families wait too long. The 6-month-prognosis rule is a rule of thumb, not a deadline. Hospice is care, not surrender. Earlier hospice election typically MEANS the patient lives longer and more comfortably than the families who waited.

The caregiver burnout patterns we see: • Sleep debt that compounds • Anticipatory grief — grieving someone who hasn't died yet • Loss of personal identity ("I'm just mom's caregiver now") • Isolation from friends who don't understand • Resentment toward absent siblings • Health decline in the caregiver themselves The five-minute self-check: • Have you slept 6+ hours in the last 3 nights? • Have you eaten a sit-down meal in the last 24 hours? • Have you talked to someone OTHER than the patient today? • Have you been to YOUR doctor in the last 12 months? • Are you doing this alone? Resources for caregivers in the community (5 min): • Local respite care • Sibling re-engagement scripts • When and how to hire help • Caregiver support groups (often free)

• Recap (3 min) • The free 47-point family readiness checklist (yourname.planyourpassing.org/resources/checklist) • The free 20-min consultation offer (private, no judgment) • The community resources handout • Pause. Stay 15 minutes after for anyone who wants to talk one on one — this is the most-used part of the workshop. People who didn't say a word during the session often want to talk privately afterward.

Don't ignore it. Don't fixate on it. Acknowledge: "Take whatever time you need. We're going to keep going, and you're welcome to step away or stay — both are fine." Continue the workshop. Don't make them the center of attention. Check in privately at the next natural break (5-10 min later). If a staff member or family member is with them, let that relationship hold the moment. We're the speaker, not the counselor. If they're alone and clearly distressed, quietly ask if they want to step out together for a moment.

Sometimes anger surfaces as grief. Sometimes it's about a sibling fight that hasn't resolved. Sometimes it's frustration with the medical system. Acknowledge: "What you're describing sounds really hard. I hear you. There's a lot in our system that's broken — you're not wrong to be frustrated." Don't argue. Don't defend "the system." Don't try to fix it in the room. Offer the one-on-one conversation afterward. Most of the time they want to be heard, not solved.

This happens often in these rooms. Acknowledge: "Thank you for sharing that. I'm so sorry. The first 30 days are some of the hardest, and the fact that you're here tonight means you're already doing the work." If they want to share more, let them. If they don't, move on. DO NOT use them as a teaching example. DO NOT say "and this is exactly why we recommend..." After the workshop, offer the free consultation. Make sure they know they're not alone.