What to do if…
you are asked to decide about moving a relative to comfort-focused care and you feel unprepared

What to do now

1. Ask the team to say the decision in plain terms and write it down.
   Say: “Please tell me exactly what comfort-focused care means here, what may be stopped, what will continue, and what will be actively done for comfort. Please document the plan in the notes.”

2. Check whether your relative can decide about this question today.
   Ask: “Does my relative have capacity to decide about this specific treatment plan today?” If they do, the decision should be theirs, with support if needed. If they do not, ask: “Who is the responsible clinician, and how will family be consulted about what my relative would have wanted?”

3. Look quickly for any existing wishes or appointed person.
   Check your phone, emails, files, or family messages for:

   • an advance decision to refuse treatment,
   • an advance statement or written wishes,
   • a health and welfare lasting power of attorney, welfare power of attorney, welfare guardian, court-appointed deputy, or other document that may be relevant to health or welfare decisions where your relative is being treated.

   Tell the team immediately if you think any of these exist, even if you cannot produce the paperwork yet.

4. Ask for a structured family meeting today, even if brief.
   Ask for the lead doctor or senior doctor, a senior nurse, and the palliative care team if available. If you cannot meet in person, ask for one scheduled call with the key people present.

5. Ask four grounding questions.

   • “What are the realistic best-case and most likely outcomes if active treatment continues?”
   • “What harms are you trying to prevent by focusing on comfort, such as breathlessness, agitation, pain, or repeated invasive procedures?”
   • “What comfort measures will be increased now, such as pain relief, medicine for breathlessness, nausea relief, mouth care, calm surroundings, and family visiting?”
   • “Which treatments could still be used if they help comfort, such as oxygen, fluids, or antibiotics for a distressing infection?”

6. Discuss emergency planning as its own conversation.
   Say: “Are you also asking about CPR, a DNACPR form, or an emergency care plan such as ReSPECT? If yes, please explain the likely benefit and burden for my relative, and document the decision separately.”

7. Choose one family contact for the next 24 hours.
   Pick one family spokesperson. Ask the ward who to contact for updates, such as the named nurse, nurse-in-charge, or medical team, and what times are realistic.

8. If you feel pressured or the plan is unclear, escalate calmly.
   Say: “Can we involve the palliative care team or the senior clinician on call before this is finalised?” If you are not being heard, ask how to contact PALS in England, or the local patient advice, liaison, complaints, or advocacy route elsewhere in the UK.