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It's very important for patients and family members to decide how they are their loved ones would like to spend their final days.  But, how do doctors go about addressing the delicate issue of end-of-care planning?

With a growing population and people living longer with chronic disease, researchers said it is increasingly important for patients and relatives to decide how they want their loved ones to go.  Researchers said for it is important for physicians in both hospital and primary care settings to address this issue with sensitivity.

Researcher writing in the Canadian Medical Association Journal have created a "conversation guide" to help doctors through these sensitive discussions with patients in hospital and their family members.

"Today health care is siloed and very fragmented," guide author Dr. John You of McMaster University's Michael G. DeGroote School of Medicine said in a news release. "The hospital-based physician almost never has a pre-existing relationship with a patient."

You and his team created a conversation guide to help hospital-based doctors better understand patients' life stories, their concerns about dying and wshes for end-of-life care.

"The hope is that this conversation guide will give front-line physicians a practical set of tools and information that will make them more comfortable in engaging patients and families, be comfortable with topics and guide them in identifying the patients most in need of engaging in conversation," said Dr. You.

Researchers said the conversation guide offers practical advice in areas like identifying patients at high risk of dying, communicating prognosis, explaining patient values around their care plan, involving substitute-decision makers in care planning and documenting a patient's wishes.