Table 1:

Preparing Caregivers for Surrogate Decision Making to Prevent Adverse Caregiver Outcomes

Task	Words to Use
Identify and overcome barriers to communication	[PT]: Are you able to talk with [CG] about your concerns/hopes/wishes … …if your heath were to get worse …about the end of your life Can we arrange for [CG] to come to your next appointment? [CG}: I’d like to use today’s visit so that [PT} can start to talk to you about things that are important to [PT]. While these can be hard to discuss, knowing these things will make it easier if you ever have to make a decision on [PT’s} behalf.
Encourage [PT] to tell a story of how the final chapter of life might look, exploring effects on [CG]	[PT]: Have you thought about how you would like things to go if you got very sick and it looked like you might not recover? Where care would be delivered Consideration of loves ones’ needs [CG}: I need you think about what [PT] has just said about (wanting to die at home) (never wanting to go to a nursing home). Can we talk about what could get in the way of your being able to make that happen?
Anticipate the factors that might enter into surrogate decisions	[PT]: At a time when you get very sick, the doctors might make recommendations based on the symptoms you are having or the likelihood that treatments will help. How do you feel about [CG[ using these recommendations? [CG}: How do you think you can use what you know about [PT] and what the doctors will be telling you if you need to make a decision for [PT]?

PT = Patient CG = Caregiver