Let the doctor know that you want to discuss bad news openly

"A patient's health practitioners should notice if he isn't getting better or is starting to show signs of decline, and they should be able to talk openly about what's happening," says Keyssar. Because you see the person you're caring for often and you're hopeful for his recovery, you and family members may not notice some of these signs. Or you may notice changes, but not recognize them for what they are -- the beginning of the end. A health practitioner can help you understand and adjust to what's happening.
Open, direct communication with the doctor about preparing for death can give you and the patient the gift of experiencing your last months or weeks together as fully as possible.
"It can be difficult when you realize after the fact that you had very little time left with a person and didn't know it," says Keyssar, who suggests that caregivers and family members ask doctors to be as straightforward as possible about what to expect when signs of decline start to appear. "It's wonderful if you know what's happening and can say to a person, 'We've had some really great years. Can we have a conversation about how you want it to be as we get near the end? What are your hopes and fears? How can I help?'"